An awake craniotomy is a surgical procedure during which we remove a section of the skull in order to access the intracranial compartment. At the end of the procedure, the section of the skull is returned to its previous place (1) while the patient is awake during the entire or part of procedure. Today, this approach is widely used because of its benefits in the surgical procedures of eloquent regions in the brain. In terms of premedication for the awake craniotomy, a general consensus on whether its administration to the patient is necessary or which medication should be administered has not been reached yet. Furthermore, the consensus on which pharmacological technique is the best for this procedure has also not been reached. Today, we have the knowledge of three different techniques for the awake craniotomy: the SAS technique, which combines GA and the awake period during mapping; the MAC technique, during which the patient is under sedation; and AAA technique which combines the local anesthetics and analgesics. When comparing these three anesthesiological techniques, we can conclude that the SAS and MAC techniques are equally safe and favorable for the patient, but which of these techniques will be used depends only on the surgeon and the anesthesiologist. However, the AAA technique requires further research.