Customized surgical approaches that take into account the anatomy and pathology of individual patients have become a standard in neurosurgery. However, precise preoperative planning is necessary to achieve optimal therapeutic results. Radiological imaging modalities are used before and during surgery to delineate the patient’s anatomy and neurologic function. This chapter discusses the challenges of managing and organizing the surgical procedure for gliomas before the technical aspect of the surgery. The use of different pre- and intra-operative instruments offers advantages and disadvantages, and the choice must be made in a collaborative manner and after careful evaluation of the patient’s images. Minimally invasive approaches, such as keyhole surgery with the aid of an endoscope and/or neuronavigator, offer significant advantages in terms of operative risks but must be carefully selected based on the individual needs of the patient and the operating room space.