Aim:Early postoperative neuropsychological dysfunction is common after intracranial surgery. Although it is primarily caused due to the surgical procedure, it should be considered in intraoperative processes. Therefore, we aimed to compare the incidence of postoperative neuropsychological dysfunction in patients managed with cerebral saturation monitoring versus traditional approaches.Material and Methods:A hundred patients undergoing elective intracranial surgery were divided into two groups to receive intraoperative management via cerebral saturation monitoring (Group O) or the conventional approach (Group C). The postoperative neuropsychological function was evaluated by the antisaccadic eye movement test (ASEM) and the Mini-Mental State Examination (MMSE). These tests were performed preoperatively and postoperatively on the first, second, and fifth days. The time for the modified Aldrete score to reach 9 (MAS 9), adverse effects, and pain using a Visual Analog Scale (VAS) scores were recorded.Results:Patient characteristics and surgery data were not statistically different. The MAS 9 of group O was significantly lower than that of group C (p<0.001). The MMSE at the postoperative 1, 2, and 5 days were significantly higher in Group O compared to Group C (p<0.001). ASEM was similar between groups. Group O was subdivided according to the type of surgery applied with diagnosis, and there were no statistically significant between-group differences in terms of areas under the curve for the cerebral regional oxygen saturation. There was no between-group difference regarding the mean arterial pressure at any time perioperatively. The heart rate at 80, 90, 100, and 110 min intraoperatively was significantly higher in group C than in Group O.Conclusion:Intraoperative cerebral oxygenation monitoring can reduce patient mortality and morbidity by allowing early postoperative neurological evaluation to detect potential neurocognitive deficits.