Is craniotomy scary? When many patients hear about craniotomy, they are afraid of it like a tiger. In fact, the development of brain surgery is very mature now. A small incision and a bone window can open up a very large tumor. The so-called craniotomy is to saw out a bone window in the skull, through which the intracranial lesion is removed. The sawed off bone can be put back after surgery without any effect. The quality of craniotomy does not depend on the size of the bone window and incision, but on two factors: 1) the extent of intracranial lesion removal; 2) the extent of brain function protection. Since the brain is different from ordinary organs, its function is particularly important and should be protected with special care. Therefore, the best is to have the lesion completely removed and no damage to the brain function. Sometimes it cannot reach such perfection, then it has to be considered comprehensively. The reason why it is difficult to open an auditory neuroma is that it is difficult to protect the facial nerve. But the facial nerve is very important, and patients with peripheral facial palsy are in particular pain. We often spend a few more hours intraoperatively to protect and separate the facial nerve in order to say that, but we think it is worth it. Neurosurgery has evolved to the point where there has been a great deal of progress around the central point of functional protection. New equipment has emerged in abundance and there have been major breakthroughs in surgical concepts. Craniotomy is no longer a destructive thing, but a very delicate and safer thing.