Central nervous system (CNS) squash cytology (CSC) has established itself as a technically simple, rapid, inexpensive, fairly accurate, and dependable intraoperative diagnostic tool. It helps neurosurgeons immensely when management is dependent on it.: To asses the efficacy of squash cytology in the intraoperative diagnosis of CNS lesions by comparing with histopathological diagnosis. The present study is a prospective study done for one and a half year includes 43 patients who presented to the department of neurosurgery with complaints of a headache, backache, epilepsy and radiologically diagnosed to have a space occupying lesion. Only the cases where either squash cytology or frozen section was performed were included in the study. : In the present study, it is observed as Out of 43 cases, squash cytology is performed in 42 cases in which histopathological diagnosis is correlated in 36 cases with a diagnostic accuracy of 85.7%. The diagnostic accuracy of squash cytology in common CNS tumors gliomas and meningiomas was 92.8% and 100% respectively. Out of the 43 cases, the frozen section is performed in 42 cases of which histopathological diagnosis is correlated in 37 cases with a diagnostic accuracy of 87%. The diagnostic accuracy of frozen section in common CNS tumors gliomas and meningiomas was 85.7% and 100% respectively. The sensitivity and specificity of frozen section in the identification of tumor was 94.7% and 100%. The positive predictive value and negative predictive value of the frozen section in the identification of the neoplastic lesion was 100% and 66.6% respectively.Squash cytology and frozen section are preliminary diagnostic methods, which should always be followed by a definitive histopathological diagnosis.