A total of 79 patients with a suspect space occupying intracranial lesion was operated stereotactically. After CT and MR image acquisition, entry and target coordinates were defined and biopsy trajectories were simulated preoperatively using a special planning software. Biopsy specimens allowed a satisfactory neuropathological examination and diagnostic result in 74 of 79 (93.7%) cases. In the remaining 5 of 79 (6.3%) patients, a glioses was diagnosed in three cases; in only two patients could no pathological process be proved. 10 of 79 (12.7%) patients showed an intraoperative bleeding out of the biopsy-cannula during serial stereotaxy, which was associated with a CT-detectable hematoma up to 7 mm in diameter in only three cases (3.8%). In no patient was the detection of intracerebral bleeding the reason for any neurological deficit. In summary, the high percentage of satisfactory neuropathological diagnoses, the low rate of stereotaxy-associated morbidity and the comfortable and safe use of computer and stereotactic devices justify this kind of minimally invasive diagnostic measure as a routine method.