The combined application of surgical treatment, radiation therapy and chemotherapy has significantly improved the survival and quality of life of patients with glioma, but the treatment of glioma still lacks radical means. Maximizing tumor resection while striving to protect and improve brain function is the ultimate goal of surgical treatment of glioma. The extent of surgical resection remains a major factor affecting postoperative glioma recurrence and patient survival. Numerous clinical studies have demonstrated that total excision of gliomas, when possible, not only helps to improve survival and KPS scores and improves the prognosis of glioma patients, but also treats tumor-associated epilepsy, especially refractory epilepsy. The functional areas of the brain are mainly the network of cortical and subcortical structures that are closely related to language, motor, sensory and visual functions. The literature reports that approximately 82.6% of low-grade gliomas and 53.9% of high-grade gliomas involve functional areas. The surgical treatment of functional gliomas is a difficult clinical task in neurosurgery, and the main conflict is the trade-off between the extent of lesion excision and the patient’s neurological function. Statistics of a large number of clinical cases confirm that if functional zone surgery is not applied with functional localization techniques, permanent functional impairment occurs in 13% to 27.5% of patients after surgery. The core technique of functional area glioma surgery is the functional brain localization technique, which is a combination of brain imaging, intraoperative electrical stimulation and electrophysiological monitoring. It improves the safety of glioma surgery and plays an active role in achieving maximum removal of glioma while maximizing preservation of brain function. Preoperative brain imaging techniques Routine Preoperative MRI T1WI, T2WI and enhanced MRI are routinely performed, and the central region can be roughly determined based on the fixed anatomical landmarks on MRI. The location of the tumor, adjacent structures and blood supply can be generally localized. Due to the individual differences and the occupying effect of brain tumor, the functional area is pushed and remodeled, so there is some error in using classical anatomy to locate the functional area. Therefore, conventional MRI cannot accurately localize the functional areas. Functional neuroimaging Positron emission tomography (PET) is a nuclear medicine tool that obtains information on cellular activity or metabolism by scanning the movement of a radioactive tracer in the body and using it for imaging. It can reflect the functional and metabolic status of the brain at the molecular level. However, PET requires intravenous tracer injection, risks low levels of radiation, has low spatial and temporal resolution, and is prohibitively expensive. Functional magnetic resonance imaging (BOLD- fMRI) allows functional analysis of the human brain under safe and non-invasive conditions with high temporal and spatial resolution. fMRI can non-invasively show the relationship between the tumor and functional areas, thus helping to select the best surgical plan or pathway. Currently fMRI has been widely used for preoperative localization of motor and sensory functional cortices, language dominant hemisphere, and language-related functional areas. Magnetoencephalography (MEG) and magnetic source imaging (MSI) are new non-invasive methods that reflect brain function by detecting changes in magnetic fields generated by excitation of nerve cells. MEG and MSI are currently used to determine the sensory, motor, and language functional areas of patients preoperatively, and as a non-invasive method MEG can replace the Wada test to evaluate the language dominant hemisphere. Diffusion tensor imaging (DTI) is a method to evaluate the structural and physiological state of biological tissues by measuring the diffusion process of water molecules, and for the first time, DTI fiber tracing can non-invasively confirm specific white matter fiber bundles in the living brain. BOLD-fMRI in combination with DTI can be used preoperatively to define the spatial anatomy of the tumor in relation to cortical and subcortical functional areas, to assist in surgical planning and to estimate the patient’s prognosis. Preoperative specialist evaluation Neuropsychological evaluation The mini-mental sate examination (MMSE) assesses the cognitive function of patients in five areas: orientation, memory, attention and calculation, recall and language. The Adinburgh Handiness Inventory (EHI) was used to determine handedness. There are reports of non-invasive methods such as magnetic resonance imaging (fMRI) or magnetoencephalography (MEG) instead of the Wada test to determine the language dominant hemisphere, but the Wada test is still the gold standard for determining the language dominant hemisphere. The Chinese version of western aphasia battery (WAB) was used to evaluate the neurological status of language function: the scores were based on fluency, comprehension, repetition, naming, reading, and writing. Motor function was rated using the standard motor function scale (Table 1). The Karnofsky performance status score (KPS) was used for functional status. Other cognitive functions, such as number, object naming, and spatial orientation, were assessed and compared before, during, and after surgery using a homemade scale in this study group.