Intracranial cavernous hemangiomas are divided into intracerebral and extracerebral types, with the majority being intracerebral. Intracerebral cavernous hemangiomas are prone to recurrent bleeding, producing symptoms such as headache and epilepsy, and in specific areas such as the basal ganglia, hemiparesis. Treatment is individualized, and the weight of surgical trauma, cost, and expected outcome should be evaluated with a view to maximizing the gain with minimal cost. Minimally invasive surgery is the key, and the use of a transcerebral sulcus approach would be the best option. The following case is a thalamic cavernous hemangioma with a better result using a trans-lateral fissure insula procedure. Preoperative right thalamic cavernous hemangioma Postoperative review CT showing total resection Removed tumor