Glioma is the most common intracranial tumor, and its incidence rate stands at 40-60% of intracranial tumors. The current principle of treatment is still surgery as the most important means of treatment, and the resection rate of surgical tumors is positively correlated with the patient’s survival, so improving the resection rate of tumors is the fundamental method of treating gliomas, and the degree of resection of tumors is closely related to the tumor’s location, the local anatomical structure, and the surgeon’s ability. The degree of tumor resection is closely related to the location of the tumor, local anatomy, and the ability of the surgeon. Surgery of glioma in the insula has been a severe test for neurosurgeons, and the complexity of the insula and its surrounding structures has always been a forbidden area of neurosurgery for many years. In recent years, with the advancement of anatomy and the application of fiber stripping, neurosurgeons have gained a deeper understanding of the structure of the local grey matter and the shape of the white matter fibers and their interconnections, and the total resection of insula gliomas has been made possible, and some neurosurgeons have made exploratory resections of the insula. Some neurosurgeons have explored the surgical treatment of insular gliomas, summarized some experiences and achieved certain results, but the experience is still insufficient. How to ensure the neurological function of patients and achieve the satisfaction of tumor resection requires neurosurgeons to be good at summarizing experience and dare to challenge to achieve the best results. In recent years, we have tried to perform insula glioma surgery, and have accumulated some experience and achieved satisfactory results, with almost 90% of patients being able to achieve total tumor resection and good protection of neurological function.