We present herein clinical experience of neurosurgical anesthesia and cerebral protection in 66 cases, including 27 with supratentorial mass, 28 posterior fossa tumor and 11 cerebral vascular deformity. Our methods for the control of intracranial pressure (ICP) and cerebral blood flow (CBF) during neurosurgical anesthesia were as follows: (1) avoidance of the drugs adversely influenced on ICP; (2) use of lidocaine iv. infusion; (3) prevention of hypercapnia; (4) maintenance of adequate perfusion of vital organs; (5) drainage of cerebrospinal fluid if necessary; (6) use of free radical clearing agents. We conclude that they are key points of effective control of ICP and maintenance of CBF so as to prevent cerebral ischemic effect on neurological function.