Due to primary diseases of neurocritical care unit (NCU) patients, they have particularities with low level of consciousness, poor airway protective ability, damaged respiratory drive and respiratory motor conduction pathway. Such patients have higher rates of weaning difficulty, delayed extubation, extubation failure and tracheostomy. There are several guidelines on weaning and extubation for intensive care unit (ICU) patients, while there are no guidelines for for NCU patients. Therefore, we reviewed current guidelines and recommendations on weaning and extubation in both ICU and NCU patients suggesting considerations of neurological condition, level of consciousness and presence of airway protective reflexes before extubation, moreover, we introduced researches about protocols of weaning for NCU patients and related predictors.