Although cranial gamma knife treatment has more advantages compared with craniotomy, it is impossible to completely replace craniotomy. The specificity of the cranial brain itself determines that gamma knife surgery requires relatively strict indications, so we can only say that cranial gamma knife can selectively replace part of the craniotomy, there is not and can not replace all of the surgical craniotomy. This requires us to use a scientific point of view, without prejudice to correctly understand, master and evaluate the relevant treatment techniques and methods. I think the correct understanding should be cranial gamma knife as a mature cranio-cerebral disease treatment, and traditional craniotomy, micro-neurosurgery, intravascular interventional surgery, brain stereotactic surgery, etc. together in neurosurgery play an increasingly important role, is one of the important treatment means of neurosurgery, for cranio-cerebral disease to provide a clinical choice of treatment methods. Wide The successful application of cranial gamma knife in clinical practice, especially the affirmation of efficacy, unknowingly also brings influence and changes to some concepts and ideas of craniotomy. In the past, surgery for brain tumors emphasized total resection of tumors, especially benign intracranial tumors, and only total resection of tumors was possible to cure or improve the survival of patients. Only complete resection of the tumor could cure the patient or improve the patient’s survival. However, the result of such excessive pursuit is sometimes at the cost of patient’s life or important functional damage, which undoubtedly increases the risk of mortality and disability and seriously affects the quality of patient’s survival. For example, if the surgical operation of auditory neuroma damages the facial nerve, the patient’s postoperative corners of the mouth will be distorted, salivation will occur, and one eyelid will not be able to close, etc. The patient’s face will be extremely damaged, which will cause serious damage to the patient’s physical and mental health and seriously affect the patient’s quality of life. Now such serious dysfunction is less common in the clinic, because the purpose of craniotomy, especially benign tumors located in important functional areas, there is no longer a need to risk life or important functional damage to overemphasize the total removal of the tumor, but to ensure life and function intact under the premise of removing the tumor as much as possible, minimize the volume of the tumor, and then treated by cranial gamma knife tumor residue after surgery. In this way craniotomy and gamma knife treatment cooperate and synergize with each other to improve the overall efficacy of the disease on the one hand, and reduce the mortality and disability rate of the operation on the other hand, thus improving the quality of survival of patients. It can be said that surgery itself has now become more human-centered, function-based, and life-based, and this change in surgical concepts and thinking is partly due to the cranial gamma knife. As cranial gamma knife surgeons have become more profound in their understanding of stereotactic radiosurgery, more experienced in treatment, and more accurate in their grasp of indications, cranial gamma knife treatment and craniotomy have now become quite close and coordinated, playing their respective advantages and roles in the clinic.