This soundless video shows the aspiration and drainage of a left insular cerebral abscess via a transsylvian approach. The patient is a 71-year-old right-handed man who presented with a two-month history of headache and speech problems. Specifically, he suffered episodes of garbled speech and word-finding difficulties. At two-month follow-up, his speech had returned to normal and his headache had resolved. For a review of treatment of cerebral abscesses, please refer to the following: Neurosurgical FOCUS Jun 2008, Vol. 24, No. 6, Page E3: E3.