Objective: This study was designed to assess the influences of arterial pressure continuous output (APCO) derived stroke volume variation (SVV)-guided fluid management on postoperative complications and outcome in the patients undergoing supratentorial neoplasms surgery. Methods: Sixty-six patients undergoing elective supratentorial neoplasms surgery were randomly divided into the control group and APCO group. Before the induction of general anesthesia, colloids 3 ml/kg were given in the two groups followed by crystalloid infusing according to physical requirement. The degree of brain edema was assessed one day postoperative. Results: Intraoperative colloids and total infused fluid volume were significantly higher in APCO group than control group. The degree of brain edema at 1 day postoperative was not significantly different between the two groups (3 (2, 4) vs. 3 (2, 4), P=0.96). The lactate concentration at the end of surgery in the patients of APCO group was significantly decreased compared with baseline (P<0.001). The incidence of postoperative complications (4 vs. 11; P=0.047) was decreased in the APCO group. Conclusions: Fluid management guided by SVV during supratentorial neoplasms surgery is associated with a lower incidence of postoperative complications and do not induce additional risk of brain edema.