BACKGROUND Consistently raised intracranial pressure is a common final pathway to morbidity/ mortality in neurosurgical conditions like head trauma, hydrocephalus, intracranial tumours and infective central nervous system diseases that cause significant cerebral oedema. This underscores the need for early diagnosis and prompt management of raised intracranial pressure. There is paucity of knowledge on the utility of the novel smartphone fundal photography as a rapid, objective, non-invasive assessment tool for raised intracranial pressure in neurosurgical patients. AIM To determine whether smartphone(Tecno Camon X with 16 megapixel camera) fundal photography features of raised ICP can accurately predict the computed tomographic (CT) findings suggestive of elevated intracranial pressure (ICP) in neurosurgery patients. METHOD This is a twelve month prospective cross-sectional study to determine the effectiveness of smartphone fundal photography in predicting the neuroimaging findings in patients with clinical suspicion of raised intracranial pressure. Dilated ocular fundal photography examinations, using the Peek Retina ophthalmoscope adapter mounted on a smartphone, was done on 82 patients with clinical suspicion of raised intracranial pressure. Fundal photography findings were recorded as pictures or videos for disc analysis. Patients subsequently had neuroimaging and results analysed for radiological features of raised ICP. These are then correlated with fundal photography findings. ANALYSIS Statistical analysis was done using the Statistical Package for Social Sciences (SPSS) version 21, Chicago, Illinois. The specificity and sensitivity by which fundal photography findings predict Neuroimaging findings of increased intracranial pressure was determined using Spearman’s correlation coefficient. Statistical significance was inferred at p value of < 0.05. RESULTS A total of 82 adult patients were recruited for this study. The mean age of patients in this series was 38.7yrs (±21.3). Chi-square analysis of independence showed a statistically significant relationship between radiological signs of raised ICP and absence of spontaneous retinal venous pulsation(SRVP) with a p-value of 0.001( 2= 10.847). There was no significant relationship observed between papilloedema or retinal haemorrhage and radiological signs of raised ICP. However when the fundal photography signs were aggregated, there was significant relationship between the fundal signs of raised ICP and radiological signs of raised ICP.( p-value 0.004, 2 =8.211). The sensitivity of smartphone-fundoscopy-detected papilloedema in predicting radiological signs of raised ICP was 43.2% while the specificity was 100%. Absence of SRVP has a sensitivity of 100% and specificity of 92.6% in predicting radiological signs of raised intracranial pressure.