The common methods for trepanation are:

- scraping
- grooving
- boring-and-cutting
- rectangular intersecting incisions.

The scraping technique was probably one of the most common methods and was distributed chronologically from ancient Egypt to the Renaissance period in Italy.

The grooving technique was also frequently used in many parts of the world and is currently still performed in Kenya.

The boring-and-cutting method was used in Peru. It was also described by Celsus in Roman times, then adopted by Arabs, and became standard in the Middle Ages.

A method in which four straight incisions were made was commonly adopted in Peru, but is also known in Neolithic France, Iron Age Palestine, and modern Africa.

The classification of trepanations currently in use today includes: (1) real or surgical trepanation (trepanatio ante mortem), defined as any opening of the skull on a living person; (2) ritual trepanation (trepanatio post mortem sive post huma), any posthumous opening with the aim of obtaining a part of the skull vault to be use as an amulet or other use; (3) symbolic trepanation, an operation on the skull roof of a living person that does not affect the inner compact layer of the bone.

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