Present concept is that high resolution and specialized neuroimaging precludes the need for intraoperative pathology consultation. Then what is the stance of intraoperative diagnostic techniques like squash and imprint cytology in such a scenario? Neurosurgical operations were once considered grave with high morbidity and mortality however present situation is not so. Refinement of procedures and minimally invasive techniques have come up however here comes the need for pre-operative and intraoperative diagnostic accuracy. Sometimes, when surgeon and radiologist both are at a cross road the pathologist’s opinion becomes imperative. Neurosurgery differs from other surgery in the basic technique that a neurosurgeon goes through the lesion and not around it so margin clearance is not the aim of intraoperative CNS cytology. The aim of neurosurgeons is to minimize residual neurodeficit along with removal of the lesion. Intraoperative cytology helps to confirm that proper diagnostic tissue is biopsied in minimally invasive procedures or very small lesions or lesions present in dangerous areas that control vital body functions.