This prospective randomized study was conducted to evaluate the effects of low-flow and high-flow anesthesia on intracranial dynamics and cerebral oxygenation in patients undergoing laparoscopic hysterectomy in the Trendelenburg position. Intracranial pressure was assessed noninvasively using optic nerve sheath diameter (ONSD), and cerebral oxygenation was monitored using near-infrared spectroscopy (NIRS). Changes in these parameters were assessed under standardized pneumoperitoneum and positioning conditions, and comparisons between anesthesia flow groups were performed according to the predefined study protocol.