Anatomical comparisons between ultrasound images and magnetic resonance imaging (MRI)/computed tomography (CT) preoperative images were performed in four ultrasound-assisted image-guided intracranial surgeries. An ultrasound scanner connected to a surgical navigation system allowed the neurosurgeon to acquire useful views from that integration, offering an improved method for visualization. This surgical navigation device and associated ultrasound provides real-time brain shift correction. The accuracy of navigation depends on the identification of the anatomic structures. Despite some limitations of the ultrasound images, the ability to compare preoperative MRI and intraoperative ultrasound proved useful to the surgeon.