By combining imaging and targeted therapy into a single platform, theranostics, an emerging field in neurological diseases, has the potential to completely transform diagnosis and treatment. Alzheimer's disease, Parkinson's disease, multiple sclerosis, glioblastoma, epilepsy, and other neurological conditions pose a number of complex challenges, such as difficulties in early diagnosis, restrictions in the delivery of drugs across the blood-brain barrier, and a lack of real-time therapeutic monitoring. Molecular imaging methods, such as PET and MRI, are utilized in theranostic approaches, along with drug delivery systems based on nanotechnology that can cross the blood brain barrier. Functionalized nanoparticles improve personalized medicine by enabling accurate targeting and concurrent imaging and treatment. Amyloid-PET tracers and therapeutic agent-loaded nanocarriers are two disease-specific theranostic approaches that have shown promise in preclinical and clinical research. For increased accuracy and effectiveness, future directions focus on combining state-of-the-art technologies, such as artificial intelligence and CRISPR-Cas9 gene editing. Theranostics holds revolutionary potential for managing neurological disorders by enabling early detection, personalized therapy, and dynamic treatment monitoring, despite translational challenges related to blood-brain barrier penetration, safety, regulatory barriers, and cost. To advance clinical outcomes in neurology and move these innovations from the bench to the bedside, more interdisciplinary research is essential.