Stereotactic biopsy is nowadays considered a diagnostic procedure indispensable for anyone dealing with neuro-oncology, though its role is still debated especially in comparison with the one of the direct surgical approach. The Authors examine the indications of stereotactic biopsy in the management of intracranial expanding lesions, reviewing their personal series of 793 cases surgically treated in the last 7 years; of these, 210 underwent stereobiopsy. The possibilities of the procedure, its reliability as well as the possible complications are analysed in detail. Finally, the crucial role played by the pathological examination in the diagnosis of neoplasia is particularly stressed.