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Background/Objectives Lumbar punctures (LPs) continue to hold an essential role in diagnosing neurological conditions despite being an invasive investigation in an era of evolving neuroimaging. At our institution there has been a significant rise in diagnostic LPs with a particular demand for neurodegenerative CSF analysis. This audit evaluates the safety and efficiency of the LP service at Concord Repatriation General Hospital (CRGH).Methods A retrospective audit was conducted on 64 patients who underwent LPs at CRGH between January and June 2024. Data were extracted from electronic medical records. Performance was assessed against Southeastern Local Health District and European Joint Programme Neurodegenerative Disease consensus guidelines. Descriptive statistical analysis was performed.Results From a safety standpoint, 45% of patients did not have appropriate laboratory investigations within 24 hours of their LP. 14% of patients had no investigations performed prior, all being outpatients.Most patients (56%) were on either anticoagulant/antiplatelet therapy and 22% of these patients’ therapy was not appropriately ceased. Only 11% experienced adverse outcomes, predominantly post-dural puncture headaches (PDPH).From an efficiency aspect, 33% of LPs, with more than half being outpatient LPs, were abandoned. 75% of these needed to be rescheduled for imaging-guided LPs due to failed bedside attempts.Conclusion This audit demonstrates areas requiring improvement for more safe and effective LPs at CRGH. The highlighted deficiencies in outpatient LP practice, along with an expected demand in outpatient CSF testing at CRGH over the coming years, allows us to focus on tailoring protocols and initiatives to better deliver the service.