Consensus guidelines were published for the first time in 2018 on the management of Idiopathic Intracranial Hypertension – a condition with an age and gender adjusted annual incidence of 2.4 per 100,000 and increasing. An audit was conducted across two sites - St George’s Hospital and Croydon University Hospital. Data was extracted on all patients admitted in 2017 with ICD code G93.2 and then those 16 or under, those who did not have IIH at the index event/it wasn’t their primary diagnosis and those with incomplete notes were excluded. The resultant cohort was 19 women, mean age 26.9 and mean BMI of 31.8. The quality standard for having lumbar puncture (100%), having brain imaging (100%), opening pressure recorded (100%) and brain imaging within 24 hours (84%) was achieved. Brain imaging performed within 48 hours was achieved in 53% due to delay in obtaining venography. Documentation of risk of teratogenicity, potential side effects and BMI was poor. Although the guidelines suggest venography within 48 hours, this would not be an easy target to meet and we would suggest that this is only needed for patients whose acuities/fields are affected, not female and not overweight.