Objective To investigate the value of craniotomy directed by awake anesthesia combined with cortical electrical stimulation in the resection of the lesions in cortical language areas.Methods A total of 21 patients whose lesions were located in or near cortical language areas were admitted to our hospital from August 2011 to December 2013. They were given craniotomy directed by awake anesthesia combined with cortical electrical stimulation. All lesions were resected under awake anaesthesia. The cortical language areas were identified by intraoperative cortical electrical stimulation (bipolar), and then the lesions were resected as completely as possible. Their clinical data such as preoperative preparation, intraoperative process, postoperative rehabilitation were retrospectively analyzed.Results Total tumor resection was achieved in 17 (80.95%) out of 21 patients, and subtotal resection was performed in 4 patients (19.05%). One case (4.76%) was found to have motor aphasia during the first two weeks of follow-up, epilepsy occurred in one person (4.76%) during the operation, and intracranial hematoma occurred in one patient (4.76%) after the operation. The gliomas of two patients (9.52%) who had used subtotal tumor resection recurred. The other patients had good clinical outcomes.Conclusions The lesions in cortical language areas can be resected by the craniotomy directed by awake craniotomy combined with cortical electrical stimulation to the utmost extent, and the language function can be protected effectively.