The integrated hybrid suite combines a traditional operating theatre with an image guided interventional suite, allowing for highly complex, advanced neurosurgical procedures to be performed efficiently and safely. The first generation hybrid operating suite, consist of an angiography table in the operating theatre, which only allows for real-time fluoroscopic imaging to be carried out. The second generation integrated hybrid suite maximises the use of intraoperative dynamic imaging and with software advancement, allows for complex imaging such as cone-beam computed tomography to be conducted without having the patient leaving the operating table or operating suite. We describe our early experience with using a second generation advance integrated hybrid suite system equipped with a robotic angiographic fluoroscopy system in performing complex neurosurgical cases and discussed the advantages of having such a system in any surgical department.