Objective: Navigated Transcranial Magnetic Stimulation (nTMS) has been little used to study Visuo-spatial (VS) circuits so far. Our work studies: I) VS functions in neurosurgical oncological patients by using repetitive nTMS (rnTMS); II) the possible subcortical circuits underneath. III) the correspondence between nTMS and Direct Cortical Stimulation (DCS) during awake procedures. Methods: We designed a monocentric prospective study, adopting a protocol to use rnTMS for preoperative planning, including VS functions for lesions potentially involving the VS network, including neurosurgical awake and asleep procedures. nTMS-based-DTI tractography allowed visualization of subcortical circuits. Statistical analyses on n TMS/DCS points were performed. Clinical results were collected pre- and postoperatively. Results: Finally, 27 patients with primitive intra-axial brain lesions were enrolled between April 2023-March 2024. Specific tests and an experimental integrated VS test (VISA) were used. The clinical evaluation (at 5±7, 30±10, 90±10 days after surgery) documented 33% of patients with ne-glect in the left hemisphere four days after surgery, and during 3-months-follow-up preservation of visuospatial function/clinical recovery [90.62% in MMSE, 98.86% in Bell Test, 80% in Clock test, 98% in OCS test]. The surgical strategy was modulated according to nTMS map. Subcortical bun-dles were traced to identify those most involved in these functions: SFLII>SLFII>SLFI. Comparison of nTMS and DCS points in awake surgery (n=10 patients) documented: Sensitivity (Se)=12%, Specificity (Sp)=91.21%, Positive Predictive Value (PPV)=42%, Negative Predictive Value (NPV)=66%. Accuracy ~63.7%. Conclusions: Based on our preliminary results, nTMS is advantageous to study cognitive func-tions, minimising neurological impairment. Further analyses are needed to validate our data.