The purpose of this article is to discuss the current imaging approaches and new techniques that have been developed in the examination and management of the patient with a brain neoplasm. These approaches and techniques include 1) functional imaging, perfusion, diffusion, localization of task activation, and dynamic circulatory changes; 2) three-dimensional imaging and techniques for tissue segmentation, surgical planning, and treatment planning; 3) positron emission tomography and single photon emission computed tomography, brain tumor diagnosis, and separation of brain tumor from radiation necrosis; 4) in vivo magnetic resonance spectroscopy, brain tumor differentiation and grading, and evaluation of the effects of therapy; and 5) future directions in the evaluation of brain neoplasms.