Surface anatomy scanning (SAS) is a powerful technique that uses T2-weighted magnetic resonance images (MRI) to visualize brain surface structures, and to precisely localize subcortical lesions. To overcome technical limitations of this method, synthesized SAS (SSAS) superimposes MR angiography (MRA) data on the SAS images. We describe our initial experience with surgical planning for the resection of metastases at the sensorimotor region in 5 patients using SSAS. Neurological deficits were assessed before and after surgical resection. Although 4 of 5 patients had mild to severe neurological deficits before surgery, three became symptom-free and no patient had an increased deficit after surgery. Our results undoubtedly provide palliative surgery for sensorimotor metastases. As SSAS is non-invasive and requires a short scanning time, this method could become a useful technique for the routine pre-operative simulation for surgery on brain surface lesions such as sensorimotor metastases.