[Abstract] Objective To find out the ideal surgical approach for glioblastoma of the speech motor area. Methods We retrospectively analyzed the results of microsurgical treatment of 27 cases of glioblastoma of the speech motor area admitted from January 2005 to December 2007 using a lateral split insular approach. Among these 27 cases, 21 tumors did not break through the insular cortex, and the tumors were completely resected under the surgical microscope after incision of the insular cortex, 6 tumors broke through the insular cortex and wrapped around the middle cerebral artery, 3 tumors were completely resected under the microscope, and 3 tumors had partial residual. The neurological symptoms disappeared or improved in 26 cases after surgery, and the neurological impairment worsened in 1 case. Conclusion The lateral split insula approach is a more ideal surgical approach to remove glioblastoma in the speech motor area, which can achieve both maximum tumor removal and good protection of neurological function. G. Xu, Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China [Keywords] Glioblastoma; lateral split insula approach; microsurgery