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Background:Tumors infiltrating the precentral gyrus remain a unique operative challenge. In this study, we explored a novel approach for awake craniotomy involving a patient playing a drum pad during resection of low‐grade glioma, with the use of preoperative navigated transcranial magnetic stimulation (nTMS)–generated diffusion tensor imaging (DTI) and high‐density real‐time electrocorticography (ECoG). Observation:A 36‐year‐old left‐handed male with a low‐grade glioma in the left hemisphere hand knob region had a grand mal seizure. We combined preoperative nTMS‐DTI with intraoperative passive functional mapping using high‐density real‐time ECoG. During an awake craniotomy, the patient played a drum pad while we assessed somatosensory‐evoked potentials (SSEPs) using a 64‐channel ECoG grid. This confirmed the absence of motor‐evoked potentials (MEPs) over the tumor area, consistent with nTMS findings. Continuous monitoring of the patient’s drum pad performance during the resection allowed for a gross total resection (GTR) of the tumor. Following the resection, he experienced some weakness in the intrinsic muscles of his right hand, which returned to full normal function at 6 months. At the end of 1 year, he remained seizure‐free. Conclusion:A multimodal mapping strategy combined with awake monitoring of drum playing enabled preservation of function while achieving GTR in a patient with a motor‐eloquent glioma.