Meta-analysis of 735 patients across ten studies reveals that awake craniotomy with intraoperative brain mapping offers no measurable advantage over conventional surgery under general anesthesia for low-grade glioma removal. Both approaches achieved comparable tumor resection volumes and similar rates of early motor and neurological complications. This challenges the growing preference for awake procedures in neurosurgical practice, which has been driven by theoretical benefits of real-time functional monitoring during tumor removal near eloquent brain areas. The findings are particularly relevant given that awake surgery requires specialized expertise, increases procedural complexity, and demands significant patient cooperation during what can be a psychologically demanding experience. While awake mapping has demonstrated clear benefits for high-grade gliomas and tumors in critical functional areas, these results suggest that routine low-grade gliomas may not warrant the additional complexity. However, the analysis is limited by the observational nature of included studies and potential selection bias, as surgeons likely chose awake procedures for more challenging cases near critical brain regions. The results underscore the need for randomized trials to definitively establish when awake surgery provides meaningful clinical advantage over traditional approaches in glioma management.