Although rare, the acute extreme hypertension experienced during RE has potential to produce cerebrovascular injury, with intense physical activity and the Valsalva manoeuvre (VM) identified as independent triggers of intracranial aneurysm rupture. More recently, RE is recommended as treatment for clinical cohorts, including type II diabetes mellitus, stroke and heart disease. Furthermore, RE appears neuroprotective, with transient increases in brain-derived neutrophic factor, a key biomarker linked to neurogenesis and neuronal survival, reported immediately following exercise cessation. Recently, RE has gained in popularity and is considered an integral part of general health and wellbeing, countering the age-related decline in muscle mass and recommended in combination with regular aerobic exercise to maintain physical function during ageing. Resistance exercise (RE) produces many favourable physiological outcomes that include increased muscular strength, metabolism and alterations in lean body mass. In this review, we summarise current literature and highlight the acute physiological responses to RE, with a focus on the cerebral circulation. Given the disparate circulatory response between aerobic and RE, primarily the blood pressure profiles, regulation of CBF is ostensibly different. However, the VM alone challenges CBF regulation and generates additional complexity when trying to dissociate the mechanisms underpinning the circulatory response to RE. Compared with aerobic exercise, RE is relatively understudied, particularly high-intensity dynamic RE with a concurrent Valsalva manoeuvre (VM). Acutely, RE can challenge CBF regulation, resulting in adverse responses (e.g. dynamic cerebral autoregulation), like those observed during RE. Cerebral autoregulation has been heavily scrutinised over the last decade with new data challenging the effectiveness of this intrinsic flow regulating mechanism, particularly to abrupt changes in blood pressure over the course of seconds (i.e. cycling) and headlined by phasic perturbations in blood pressure that challenge cerebral blood flow (CBF) regulation. The acute response to dynamic RE is characterised by temporary and bidirectional physiological extremes, not typically seen in continuous aerobic exercise (e.g. Resistance exercise (RE) is a popular modality for the general population and athletes alike, due to the numerous benefits of regular participation.