Functional magnetic resonance imaging is a safe and effective method to determine the functional brain area, and it is an extension and development of the clinical application by integrating it with neurosurgical navigation technology. During activity, arterial blood containing oxygenated hemoglobin flows into the venous bed, resulting in an increase in local oxygenated hemoglobin and a relative decrease in deoxygenated hemoglobin, leading to a paramagnetic change in venous blood and a signal change on MRI; thus providing a valuable imaging basis for brain function studies. Initially, it was mainly used for the localization of functional cortices such as motor and visual, and then gradually developed to the study of cortical localization, neurotransmission pathways and conduction sequences, and connections between functional cortices during higher neurophysiological and neuropsychological activities. The clinical application for neurosurgery is the integration of neuronavigation for functional area localization to maximize lesion removal while preserving functional areas as much as possible and reducing the disability rate. The acquisition of real and reliable functional images is a solid foundation for functional neuronavigation. To achieve this goal, a reasonable and effective functional stimulation pattern should be developed first. Functional localization of the motor cortex can be determined by repetitive simple movements (finger movements or fist clenching, etc.) or complex movements (e.g., alternating left and right foot movements, extensions, flips, etc.) stimulation patterns. Intraoperative somatosensory evoked potentials (SSEPs) and electrical cortical stimulation (ECS) have confirmed that functional images obtained by this stimulation method are accurate and reliable, and are not affected by displacement, deformation, swelling, or infiltration of the motor cortex. The second is to perform the image data rigorously. Secondly, image data processing should be carried out rigorously: since fMRI is an indirect method to detect local blood flow changes during functional brain activity rather than the neural activity itself, motor stimulation parameters (movement amplitude, intensity, frequency, etc.) and scanning sequence of the subject can affect the activation status of functional areas, so the stable acquisition of activated functional areas also depends on proper case selection and statistical analysis. We found that the intensity and range of activation of the first motor area (M1) decreased significantly the closer the tumor was to the central zone, and was replaced by the signal intensity of the supplementary motor area (SMA), and the range of activation increased significantly; this was rarely the case when the tumor was far from the central zone, which is consistent with the finding of a negative correlation between the degree of paralysis and the activation signal of the M1 area; and a positive correlation with the activation intensity of the SMA area, as found by Krings [4]. The results are in general agreement with the possible reason that the destruction of motor neurons reduces the functional activity of the first motor area and increases the compensatory activity of the supplementary motor area. Functional like fusion neuronavigation is one of the best options for neurosurgery to perform functional area surgery. Tumors in functional brain areas and their adjacent sites are difficult to accurately assess functional areas intraoperatively due to poorly differentiated lesions from normal brain tissue, lesion nudging, edema, and other factors. Intraoperative functional cortical localization by somatosensory evoked potentials (SSEPs) and electrical cortical stimulation (ECS) requires the patient to be awake, exposing a large surgical field and a long operative time, and ECS and SSEPs cannot be applied if muscle relaxing drugs are applied during surgery or the patient needs deep anesthesia, so their application is limited. The relevant fMRI examination is performed before surgery to localize the functional cortex using the fact that the fMRI signals of invasive lesions such as tumors and normal brain tissue differ in their degree of vascular maturation; the boundary between the two can be accurately defined; the fMRI images are logged onto the neurosurgical navigation system for image fusion to precisely locate the activated functional area in three dimensions from the physiological anatomy, and intraoperatively by observing The fMRI images obtained from fMRI can be displayed on the actual anatomical site with stick guidance, which can clearly provide the distance and orientation of the lesion from the functional area, the degree of displacement of the functional area, and the variation, etc. It can maximize the removal of the lesion and avoid normal tissues, and locate the functional area more precisely than ordinary navigation surgery, thus significantly improving patient healing. The advantages of fMRI navigation surgery are that the motor, sensory and speech functional areas can be precisely located with minimal brain exposure and general anesthesia, thus allowing for maximum lesion removal while protecting important functional areas of the brain, effectively reducing the disability rate and shortening the operative time. In our group of 15 cases, the functional images obtained were reliable and fused to a stable neuronavigation state, thus allowing precise localization of functional areas on the actual anatomical parts of the brain guided by the navigation observation stick during surgery, removing the lesions as much as possible and avoiding functional areas, with fewer postoperative complications and more satisfactory results. Since the current functional MRI scan is a response to preoperative brain function, and intraoperative brain displacement can affect navigation accuracy, these problems are yet to be solved. The feasibility study of applying intraoperative functional MRI for immediate scanning provides further improvement of functional MRI in the future. In conclusion, functional MRI can provide extremely valuable functional area information for functional area lesions, and combined with the navigation system, it can precisely locate the functional area intraoperatively, avoid functional area damage, reduce the disability rate, and increase the confidence of total resection of the lesion.