Objective : The aim of this work is to evaluate the different treatment modalities for peri-sylvian gliomas in order to establish a proper algorithm in the management of such cases.Methods : Patients having peri-sylvian gliomas were evaluated pre-operatively both clinically and radiologically. Patients having frontal lesions involving or proximal to the motor cortex were operated upon by awake craniotomy. Operative procedures included open biopsy, tumor debulking, subtotal resection, and gross total resection. postoperatively, patients were evaluated and followed up for their neurological integrity, deficits and outcome.Results : we operated upon 22 patients in this study; 13 males (59.1%) and 9 females (40.9%). The median age of presentation in this study was 46 years. Eight patients (36.36%) had pre-operative focal neurological deficits. Fifteen patients had high grade gliomas and 7 patients had low grade gliomas. Sixteen patients were operated upon by awake craniotomy. We achieved gross total resection in 2 patients (9.09%), subtotal resection in 10 patients (45.45%), tumor debulking in 8 patients (36.36%), and we performed open biopsy in 2 patients (9.09%). Postoperatively, 10 patients (45.45%) had transient neurological deterioration and 6 patients (27.27%) had permanent neurological deterioration. The outcome was excellent in 4 patients (18.18%), good in 7 patients (31.81%), fair in 5 patients (22.72%), and poor in 6 patients (27.27%).Conclusion : Functional neurological outcome following surgical resection of peri-sylvian gliomas is intimately influenced by several factors including; presence or absence of pre-operative neurological deficits, histopathology of the tumor, extent of surgical resection, adoption of awake craniotomy, the availability of advanced radiodiagnostic techniques such as fMRI, DTI and tractography, and the availability of advanced intra-operative neuronavigation and functional cortical and subcortical stimulation techniques.