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The benefits of early rehabilitation in critically ill patients in the intensive care unit (ICU) have been reported in recent literature. However, there are few reports concerning the safety and the risk of early rehabilitation in ICU patients with intracranial hypertension due to stroke or traumatic brain injury. Immobilized patients with intracranial hypertension cannot attempt to voluntarily move their extremities and body, therefore passive range of motion exercise tends to play a major role in early rehabilitation in the ICU, and it leads to disuse muscle atrophy in a short period of time. Our institution introduced belt electrode-skeletal muscle electrical stimulation (B-SES), which can cause more effective muscle contraction than conventional electrical muscle stimulation (EMS) to prevent disuse muscle atrophy in patients with intracranial hypertension. Although there is currently not enough data available to determine whether B-SES is safe for patients with intracranial hypertension, we applied B-SES to patients who underwent neurosurgical procedures for managing increased intracranial pressure (ICP) in the ICU. This trial revealed that ICP as well as the other vital signs in all patients did not worsen during the B-SES procedure. The purpose of this article is to discuss the safety, the efficacy, the current problems, and the future of B-SES for patients with intracranial hypertension.