Objective: Intraventricular (IV) lesions are easily being approached with the endoscope through the ventricular system, because intraventricular tumors often cause cerebrospinal fluid (CSF) pathway obstruction and hydrocephalus. The aims of endoscopy in intraventricular tumors are usually the restoration of CSF pathway obstruction, clarification of the histology, and if possible, a complete tumor removal. Methods: Twenty five consecutive cases with IV lesions were removed or biopsied with or without ETV and septum pellucidostomy. Patient information was retrospective entered into a database. Outcomes were evaluated by life table analysis. Results: Twenty five patients had completed with ETV in 16 cases; six cases by cyst fenestration, seven cases tumor biopsy 10 cases cyst removal, two cases hematoma were evacuated. 16 cases improved post-operative (clinical and radiological), three cases needed VP shunt, Three cases with same clinical as pre-operative, One case presented with paresis, Two cases operated microscopically after one year. Conclusions: The advantages of the endoscopic approach are minimal dissection and brain retraction. Reach to the target is rapid. The method of choice for removal of colloid cysts, arachnoid cysts and restore CSF pass way obstructed by lesions at the same operation.