OBJECTIVE: To find the superlative way of surgical removal of glioblastoma multiform under functional cortex by comparative study of 123 patients. METHOD: Surgical approaches include direct and total resection of tumors, trans-functional cortex or adjacent area beyond functional cortex. They were compared with partial tumor resection plus external/internal decompressive procedure, total removal of tumor plus functional cortex resection. Comprehensive analysis was made. RESULT: Total removal of tumors both trans-functional or adjacent cortex prolonged the survival time of patients. As a result, minimal damage was observed in patients with both approaches, which are helpful for recovery of impaired cerebral function. On the other hand, partial resection of tumors in spite of combining with decompressive procedure or functional cortex resection did not show the same benefit. CONCLUSION: Surgical resection of glioblastoma multiform through trans-functional cortex or adjacent cortex beyond functional area is superior to other approaches both in dealing with total tumors removal and cerebral function recovery. But the resection through adjacent cortex beyond functional area in recovery of impaired cerebral function is more effective.