Recent advances summarize mechanisms behind CAR‑T cell therapy neurotoxicity, consolidating clinical signals, imaging correlates, and biomarker profiles to refine risk stratification and mitigation strategies. The review synthesizes evidence from multiple CAR‑T programs, highlighting endothelial activation, cytokine cascades, and blood‑brain barrier perturbation as consistent elements preceding neurotoxic events. Investigators recommend updated monitoring algorithms, earlier intervention thresholds, and tailored immunomodulatory regimens to reduce severe neurotoxic outcomes. The work will inform trial design and labeling for next‑generation cellular therapies, and may accelerate biomarker‑driven patient selection to improve safety in expanding CAR‑T indications.