This study was performed in order to evaluate the accuracy and the usefulness of the cytology of crush preparation in central nervous system (CNS) lesions. Forty four intraoperative biopsies were performed at the time of craniotomy including 34 benign and 10 malignant lesions. Crush preparations were prepared from tiny tissue fragments of craniotomy products. All cases were stained with toluidine blue. Intraoperative diagnoses made on cytologic examination were compared with the final paraffin section diagnoses. Comparison between the results of the cytologic and histologic findings revealed an overall diagnostic accuracy of 88.6%. This study attests to the diagnostic accuracy of cytologic examination in CNS lesions. The detailed cytologic features are described and important criteria for the cytodiagnosis of CNS lesions are discussed. This review leads us to think that cytologic examination by crush preparation in CNS lesions is considered as a simple, safe and highly diagnostically accurate method.