Background: Fluorescence-guided surgery (FGS) with 5-aminolevulinic acid (5-ALA) is a well-established tool for improving tumor visualization in glioma surgery. However, its applications in non-glioma pathologies remain underexplored and require further investigation. Methods: A retrospective review of patients who underwent FGS with 5-ALA between January 2022 and September 2024 was conducted to assess its utility in non-glioma tumors. Results: Among 232 FGS procedures, 13 (5.6%) involved non-glioma pathologies. We categorized our patients into three different levels: high, moderate, and no response based on intra-operative 5-ALA fluorescence visualization. Our patients showed a high 5-ALA fluorescence in 10 cases (77%), mainly in the following tumors: choroid plexus papilloma, atypical teratoid rhabdoid tumor, metastatic adenocarcinoma as well as atypical meningiomas. Moderate 5-ALA fluorescence was seen in 2 cases (15%). While no 5-ALA fluorescence was seen in one case of CNS lymphoma. 90% of procedures with high response had total resection. Conclusions: Fluorescence-guided surgery (FGS) using 5-ALA has demonstrated effectiveness in enhancing tumor visualization beyond gliomas. This retrospective review highlights the potential applications of 5-ALA in various non-glioma pathologies. These findings emphasize the need for further research to refine the use of 5-ALA FGS in diverse pathologies, optimize patient selection, and expand its utility in neurosurgical oncology.