The first awake craniotomy (AC) applications were found in archaeological excavations in Peru. The successful healing rate was 55% of trephinations in 214 skulls. Coca leaves were used as a local anesthetic before the general anesthesia (GA) era. The first recorded case of AC was the epilepsy surgery performed by Sir Victor Horsley in 1886 [1]. He resected an epileptogenic lesion from a 22-year-old man. Wilder Penfield popularized the procedure in the first half of the twentieth century [2]. Compared with GA, AC has the following advantages after tumor resection: improved outcome; greater extent of tumor resection; fewer late neurological deficits, and shorter hospital stay [3–5]. © The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023.