The aging population is at an increased risk of developing several different lesions in the brain, and especially tumor suspect findings require an accurate diagnosis crucial for optimal treatment planning. Stereotactic biopsies provide a minimally invasive way to obtain tissue samples for precise diagnosis, including histopathological classification and determination of disease-specific molecular markers. The World Health Organization’s classification of central nervous system tumors in 2021 emphasizes the importance of accurate diagnosis for personalized treatment planning. Besides tumor resection, stereotactic biopsies play a crucial role in achieving these goals, and some studies have shown that the benefits of precise diagnosis and personalized treatment planning often outweigh the minimal risks associated with stereotactic biopsy, even in elderly patients. In conclusion, stereotactic biopsies are critical but suitable for diagnosing brain tumors in elderly patients.