Objective: To explore the efficacy of microsurgery via sulcus approach assisted by directional technique in the treatment of supratentorial superficial low-grade gliomas and its influence on nerve function recovery and stress response. Methods: A total of 100 patients with supratentorial superficial low-grade glioma treated in our hospital from October 2018 to October 2020 were selected and divided into a control group and an observation group, with 50 cases in each group. The control group was treated with traditional microsurgery via sulcus approach, and the observation group was treated with microsurgery via sulcus approach assisted by directional technique. The National Institutes of Health Stroke Scale (NIHSS) score and activities of daily living (ADL) score before and 2 weeks after the surgery were compared between the 2 groups. The levels of heart rate (HR), mean arterial pressure (MAP), corticosteroids (Cor) and adrenocorticotropic hormone (ACTH) were detected and compared between the 2 groups at different time points [1 day before the operation (T⁰), 1 day after the operation (T¹) and 3 days after the operation (T²)]. Results: The effective resection rate of the observation group was 96.00%, which was higher than 82.00% of the control group (P<0.05). After the operation, the NIHSS score in the observation group was lower than that in the control group (P<0.05), and the ADL score was higher than that in the control group (P<0.05). The HR, MAP, serum Cor and ACTH levels of T¹ and T² in the observation group were lower than those in the control group (P<0.05). The levels of HR, MAP and serum Cor, ACTH at T¹ and T² in the observation group were lower than those in the control group (P<0.05). Conclusion: Microsurgery via sulcus approach assisted by directional technique has a high effective tumor resection rate in the treatment of supratentorial superficial low-grade gliomas, which can reduce the neurological damage, improve self-care ability and reduce surgical stress response.