Obliteration of aneurysms, vascular malformations, fistulae and neoplasm vessels, or re-opening of occluded vessels are the main tasks of modern interventional neuroradiology, now well established in modern medicine. The importance of thrombolysis and angioplasty in acute ischaemic stroke may further increase, thus confronting the anaesthetist with an additional workload owing to the high prevalence of the disease. The heterogeneous group of evolving procedures summarized under the term 'minimally invasive neurosurgery' is described here. Despite rapid technological development of interventional neuroradiology and minimally invasive neurosurgery, the anaesthesiological problems in these fields will not diminish.