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Department of Neurosurgery İstanbul Faculty of Medicine Çapa İstanbul, Turkey The impact of stereotactic techniques on the management of mass lesions of the third ventricular region is reviewed in a consecutive series of 82 patients treated over three years using primarily stereotactic techniques. The lesions were in the ventricular cavity in 8 cases, thalamic in 26 cases, sellar or suprasellar in 3l cases, pineal in 12 cases and mesencephalic in 5 cases. A CT compatible Leksell stereotactic system was used. The patients underwent a total of 144 procedures. Objectives were biopsy alone in 47 procedures, biopsy and cyst aspiration in 33 procedures. catheterization in 5 procedures, aspiration alone in 28 procedures, interstitial radiosurgery in 27 procedures, third ventriculostomy in 1 procedure, and microstereotactic resection in 3 procedures. These objectives were realized in all cases. There were no permanent complications and no morbidity. A positive pathological diagnosis could be made in all patients. On the basis of the information obtained at biopsy, only 15 patients (18%) had to under go conventional craniotomy and resection, while 29 patients received external radiotherapy only, 19 patients had interstitital radiosurgery, 3 patients underwent microstereotactic removal of their tumors, and 8 patients received non-surgical therapy. This experience shows that the use of diagnostic and therapeutic stereotactic techniques has had a drastic effect on management of third ventricular mass lesions. obviating major intracranial operations in many patients. Keywords : Brachytherapy, brain tumor, radiosurgery, stereotaxy, third ventricle tumor