Ultrasonography has become a common method for evaluation of the central nervous system. We present our experience with ultrasonography monitoring with a burr-hole transducer for investigation of intracranial lesions. Common indications for this technique included guidance for placement of catheters, localization of masses, aspiration of cystic lesion, and confirmation of removal. Postoperative computed tomography (CT) was obtained to corroborate the appropriate procedures performed under ultrasonography guidance. Intraoperative ultrasonography provided immediate real-time information about the anatomy and pathological location of lesions. Postoperative CT findings were consistent with intraoperative ultrasonography findings. No procedure-related complication was noted and problems were minimal. Intraoperative ultrasonography using a burr-hole transducer has proved to be useful in burr-hole surgery.