As we all know, the brain is the “command” of the human body. To perform surgery on this area, it is important to remove the lesion while maintaining the normal function of the nervous system, which is very demanding. How to achieve this goal? In addition to the characteristics of the lesion, the skill level of the surgeon is certainly the most important factor. However, in a dense neurological network, even the most experienced surgeon sometimes has difficulty in identifying the “enemy” and is confused. This requires a way to distinguish between lesions and normal tissues, and to maximize the removal of lesions while preserving normal structure and function. This weapon is intraoperative electrophysiological monitoring. For example, in the case of auditory neuroma surgery, it is not difficult to remove the tumor with modern surgical techniques, but the problem lies in the protection of the facial auditory nerve and brainstem, which are very closely related to the tumor. To protect it, we must first find it, and how to capture the target when it is difficult to identify with the naked eye is difficult to accomplish even for very experienced doctors. Therefore, technological advances have spawned neurophysiological monitoring that can help us. The facial nerve fibers start from the nucleus of the facial nerve in the lower part of the cerebral bridge and travel laterally to the front. This poses a great risk for the surgeon to “go under the knife”. Using neurophysiological monitoring, especially electrical stimulation during tumor exposure and resection, to distinguish the facial nerve from other surrounding tissues, is like a map of the facial nerve to distinguish the “enemy from us” and outline the direction of the surgery, allowing the facial nerve to be protected while the tumor is removed. When the brainstem and nerves are affected, the monitor, like GPS navigation, will give an indication, so that the surgeon can adjust the operation in time and take protective measures. Electrophysiological technology is highly sensitive and credible, for the cranial nerve anatomical direction, information about the degree of nerve damage can be the first feedback, but also continuous monitoring and instant feedback on the functional state of the cranial nerve, and can even predict the functional status of the cranial nerve after surgery. With neurophysiological monitoring, the surgeon is able to demonstrate anatomical techniques more easily during surgery, providing “navigation” for the patient with an auditory neuroma. In fact, the above is only the tip of the iceberg in the application of electrophysiological monitoring technology. It can be used in surgery for different diseases of the central and peripheral nervous system. It can be used to evaluate the function of systems including the cerebral cortex, visual system, auditory system, brainstem, cranial nerves, and spinal sensory and motor pathways, peripheral nerves, etc. In developed countries, intraoperative neurological monitoring has become a standard method of neuroprotection for surgeries involving the nervous system and is very extensive. Its role is mainly in the following aspects: 1, timely detection of nerve damage caused by surgical operations and its causes, so that immediate interventions can be taken to eliminate or minimize irreversible nerve damage before it occurs and to avoid neurological complications. 2. Anatomically identify specific nerve structures to ensure that important nerve tissue is not in the immediate operative field. For example, the identification of facial nerve during the resection of auditory nerve sheath tumor and the identification of motor and sensory cortex during the resection of tumor in functional brain area. 3.Intraoperative identification of loss of functional nerve structures helps the operator to adopt more aggressive surgical strategies, such as widening the scope of tumor resection. 4.Functional assessment of specific nerve structures can guide the operator to decide the subsequent surgical steps. For example, intraoperative assessment of the extent of damage to the brachial plexus nerve to determine which portion is unlikely to regenerate and requires grafting rather than simple nerve release. 5. Accurate localization of the surgical steps that led to injury, providing retrospective analysis and information for adjustment of surgical strategy, is also an educational tool for young neurosurgeons. 6, Intraoperative neurological function monitoring also has the ability to predict postoperative neurological function, monitor intraoperative systemic changes, and give psychological comfort to patients and families. In the past 3 months, electrophysiological monitoring techniques have been used in more than 50 patients in neurosurgery, including tumor resection in functional brain area, brainstem tumor resection, cerebral aneurysm clamping, spinal cord tumor resection, spinal cord tethering syndrome and other surgeries, with satisfactory results. Since electrophysiological monitoring can reflect a wide range of parameters such as sensory, motor, and brainstem evoked potentials in real time, it provides clear guidance for doctors and escorts complex surgeries, and is an indispensable weapon for neurosurgeons. In conclusion, with the continuous development and improvement of clinical neurophysiological detection technology, its application will be expanded, and it will provide a strong guarantee to ensure the integrity of neurological function, improve the efficacy of surgery, and improve the quality of life of patients.