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Background As indications for immune checkpoint inhibitors (ICI) expand so does the frequency of immunotherapy-neurotoxicity. The precipitous onset and potential for reversibility with immunosuppression has created the need for enhanced neurology support for cancer services.Method Retrospective case note review of IO-neurotoxicity presenting to oncology and neurology-lead services in five regional centres across the UK between 2019 and 2024. Data was collected by consensus proforma.Results The clinical features of this cohort are described in an accompanying abstract. 86(79.6%) were referred to neurology: 76(88.3%) reviewed in person, 8(9.3%) by telephone/email advice and 2(2.3) discussed at MDT only. The median time from symptom onset to neurology review was 27 days(range 0-854). Neurology involvement (range 50-100%) and time from symptom onset to review (median range 18-40 days) varied according to site. Treatment approaches varied depending on whether a neurologist was involved or not (steroids 90.7% vs. 81.8%; IVIg 25.6% vs. 9.1%; PLEX 16.3% vs. 9.1%). Although symptom resolution rates were similar (43% vs. 45.5%), mRS was lower in patients with neurological involvement (mean 2.6 vs. 2.9).Conclusion Neurology involvement in patients with IO-neurotox is not universal, varies by treatment centre and is associated with differing treatment regimes and functional outcomes.schroederb2@cardiff.ac.uk