BACKGROUND: Recently, functional direct cortical stimulation mapping is frequently used during craniotomy for the surgery of brain pathology (tumors, epileptic foci etc.) within or close to the central motor area. We reviewed and analyzed our experiences to evaluate the safety and efficacy of our hospital's anesthetic management regimens. METHODS: We used three anesthetic regimens (isoflurane fentanyl; propofol fentanyl; awake craniotomy, conscious sedation analgesia) in 44 patients. We evaluated the success ratio of mapping and the incidence of intraoperative problems (seizures, changes in vital signs etc) in each regimens. RESULTS: In awake craniotomy group, functional mapping is performed successfully in all patients but there were some intraoperative problems (hypertension; 3 in 11 patients, hypercapnia; 3 in 11 patients, change to general anesthesia required; 1 in 12 patients). In general anesthesia groups, there were no significant differences between isoflurane treated patients and propofol treated patients in the success ratio of mapping (17/20 vs 11/12) and the incidence of intraoperative problems (seizure; 3/20 vs 1/12, hypertension; 2/20 vs 1/12). CONCLUSION: This results suggest that the anesthetic management regimens used in our hospital provide suitable conditions for craniotomies when brain mapping is required.