Background: Vasospasm occurs in up to 40% of aneurysmal subarachnoid hemorrhage (aSAH) cases, leading to delayed cerebral ischemia (DCI) in almost 30% of these episodes. Still, in underdeveloped countries, there is no consensual approach to its diagnosis, interventions and treatment, mostly because of the lack of resources. Our objectives were to compare the techniques employed in vasospasm management in both developed and underdeveloped countries, seeking for differences in treatments and their respective outcomes. Methods: We performed a comprehensive literature review using MEDLINE and SciELO databases. Data on locally widespread techniques were collected in a tertiary hospital of a city in the south of Brazil with 2 million inhabitants. Results: Although the most specific diagnosis method for DCI is based on clinical symptomatology, digital subtraction angiography (DSA) and transcranial pler have been widely used and recommended. DSA is considered the gold standard; however, TCD is regarded as highly specific and sensitive for observing the middle cerebral and internal carotid arteries. Whether having a clinical or imaging diagnosis, both DCI prophylaxis and treatment are based on a potent calcium channel blocker, nimodipine (high (high quality of evidence, strong recommendation). However, in Brazil, there is no such endovenous medication, leaving treatment options to oral nimodipine, surgical interventions and hypertensive drugs only. Also, the public health insurance does not cover TCD monitoring, narrowing the chances of adequate diagnosis and therapeutic procedures. Conclusion: In an underdeveloped country, low financial and technological resources impact doctors' and patients' daily lives. However, new, low-cost solutions can arise. More investment is needed in research toward budgetary and scientific accessibility.