The involvement of brain by the Paracoccidioides brasiliensis is rather frequent. Many authors call attention to the difficulty of diagnosis in almost every case, most of them being made through surgery or post mortem examination. The intracranial hypertension syndrome is the most common manifestation, almost always leading to the diagnosis of intracranial tumor. The laboratorial tests, including the spinal fluid examination, are very poor of specific data; the finding of the parasite or a positive test for blastomycosis in this fluid is rarely verified. This disease is only suspected when there are true paracoccidioidal lesions in other organs. Nine cases of South American blastomycosis of brain are reported, seven of which were submitted to surgery. From these seven, three had a fair evolution, beeing the only ones to survive. In the three cases, amphothericin B was used sometime after operation, intravenously or intratecally. The authors are favorable to the surgical management in blastomycosis of brain, whenever reliable localization signs of compression are found. After remotion of the granulomata, amphothericin B must be used in order to avoid recurrence of the disease.