Objectives: To analyze the current condition of the urgent neurologic in-hospital consultations, which may help junior doctors to manage diseases related to neurology and carry out emergency consultation. Methods: We conducted a retrospective study of urgent neurologic in-hospital consultations in a large tertiary hospital for four consecutive years (Jan 1, 2014 to Dec 31, 2017). Through the electronic medical record system, the clinical data of patients who received in-patient consultation in emergency neurology department were reviewed and analyzed. Results: A total of 1,437 cases (age range 9 to 103 years old with average age 60.3-year old, Male 54.6%) were included in the study, 57.5% of cases met the urgent consultation criteria. The departments applying for urgent consultation involved 29 clinical departments. The most common reasons of urgent consultation were disturbance of consciousness (36.0%), tic/stiffness (13.6%), limb weakness (8%) and mental disorders (5.6%).Urgent consultation diseases were divided into three categories: neurological diseases (77.8%), non-neurological diseases (10.4%), and unknown diseases (11.8%).Common neurological disorders were urgent cerebrovascular disease (33.6%), epilepsy/status epilepticus (15.8%), and metabolic or infection, toxic encephalopathy (14.9%). Conclusions: Most cases of the urgent neurologic consultation met the urgent neurologic consultation criteria. Non-neurologic junior physicians should clinically enrich their knowledge of neurological diseases.