Introduction and aims: An awake craniotomy is one of the newly introduced procedures for brain tumor surgery. It is a brain operation where speech and language functions are monitored by a clinical speech therapist with the active participation of the patient who is awake during the procedure. The aim of such an operation is to preserve the speech and language functions of the patient as well as resection of the brain tumor to the greatest possible extent. This paper summarizes the current experience and knowledge of awake craniotomy at the University Hospital in Ostrava. Methodology: Retrospective evaluation of the success of performed awake craniotomies with extirpations of tumors located in eloquent regions of the brain. The criterion for the success of awake craniotomy was the preservation of patient’s speech and language skills after surgery compared to their condition before surgery. Description of procedures, preoperative examinations, and intraoperative testing by a clinical speech therapist. Results: By comparing the results of testing speech and language functions in a group of 54 patients operated between 2013 and 2021 before and after awake craniotomy, it was found that in 40 of 54 patients there was no deterioration of speech and language functions after surgery. From a speech therapy perspective, this is a 74% success rate. Conclusion: Awake craniotomy is a new procedure introduced during brain glioma operations in eloquent regions of the speech zones. The method contributes signifi cantly to the preservation of the patient’s speech and language competences and thus to the preservation of his quality of life. Key words awake craniotomy – language functions – clinical speech therapist