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Although radiographic and clinical appearance may suggest the pathological diagnosis of a mass lesion located within vital areas of the brainstem, surgeons frequently have elected to treat patient without the benefit of a tissue diagnosis. Such an emperic approach often leads to inappropriate therapy. We present five patients with intrinsic brainstem lesions who underwent CT guided stereotactic biopsy using CRW stereotactic frame. Positive diagnosis was achieved in all cases. There was no operative morbidity, however, one patient died of postoperative intratumoural haematoma. Key Words: CT Scan, Stereotactic biopsy, Brainstem lesions.