Abstract： Objective To explore the localization of brain functional area in a Chinese-English-French multilingual patient with low-grade glioma and study the surgical method of low-grade glioma in the eloquent area using awake craniotomy and direct cortical electrical stimulation. Methods A cerebral operation was performed in a Chinese multilingual patient with low-grade glioma in the eloquent region, who spoke Mandarin, English and French. Based on semantic, speech and reading test of Chinese, English and French, functional MRI (fMRI) was conducted to map the Chinese-English-French eloquent cerebral cortex before operation. The patient received microsurgery for tumor resection with monitoring of Chinese, English and French multilingual eloquent areas under awake anesthesia, and the surgical program was guided by cortical-subcortical direct electrical stimulation, with tumor locating by B-mode ultrasound in the operation. Results Chinese, English and French eloquent cerebral cortexes were found by fMRI. All eloquent areas were located in the inferior-anterior region near the tumor, namely the posterior part of left middle-inferior frontal gyrus and superior temperal gyrus. But cortical direct electrical stimulation identified that Chinese eloquent cerebral cortex was not totally coincided with English and French eloquent cerebral cortexes, which were in the unique cortical area in the posterior part of the upper temporal gyrus; these results were different from those of fMRI. Transient supplementary motor area syndrome in the left middle-frontal gyrus was observed by subcortical direct stimulation; subtotal resection of the tumor was achieved. The patient suffered from multilingual motor aphasia of all 3 languages for 3 months. Then his Chinese recovered first, followed by English and French. After 1 year follow-up, the patient went back to his work free of aphasia of all 3 languages and had normal life with free of epilepsy. Conclusion Mapping eloquent areas using fMRI based on multilingual mission and multilingual monitoring under a waking state of the patient makes it possibe to remove the tumor in the multilingual eloquent area. Protection of mother tongue is the precondition of this kind of surgery. Linguistic function may be recovered after the maximal resection of the tumor.