Stereotactic biopsy has evolved as a powerful and safe tool to provide tissue diagnoses with minimal disruption of normal functioning brain. It plays a significant role in the management of malignant brain tumors, where the benefit of open surgery might not justify the concomitant risks. Stereotactic procedures are closed procedures, and thus direct feedback is not provided to the surgeon during manipulation of brain tissue. This difference from most other neurosurgical procedures necessitates rigor in the preoperative workup, the planning of the procedure, and the conduct of the procedure. The success of the procedure is measured by the ability of the team to make an accurate histopathological diagnosis of the lesion; in experienced hands, the rate of success should exceed 95%. Complications and mortality can be minimized with appropriate attention to detail.