Preoperative planning on the basis of combined data of navigated transcranial magnetic stimulation and MR-tractography give an opportunity to choose an optimal treatment approach in each clinical case. There were performed the examinations in 52 patients with tumors situated in projection of central gyrus. The neurosurgical interference was admitted as inappropriate in 3 (5.8%) patients. The volume of planned operation was reduced in 14 (26.9%) cases. The examination of 15 (28.9%) patients allowed choice of the correct access trajectory. The navigated transcranial magnetic stimulation assisted in performance of more safe removal of neoplasms closed to the functionally meaningful zones of the brain in 20 (38.4%).