Objective: The objective of this study is to investigate the management outcome of the endoscopic endonasal transpterygoid approaches in patients with juvenile nasopharyngeal angiofibroma (JNA).
Patients & Methods:  This is a prospective study carried out in the Otolaryngology Department, Cairo University Hospitals, Cairo, Egypt for 16 patients with JNA who underwent an endoscopic transnasal transpterygoid resection from January 2018 to October 2020. Postoperative evaluation including the clinical presentations, surgical findings and results, were included in the analysis.  Follow up for all cases was done for 18–24 months.
Results: Sixteen patients were enrolled. All patients with JNA were staged according to Fisch classification, 56.3% of patients were in stage II and IIIa (extracrania), 43.7% of patients were in stage III b and IV (intracranial). Wide MMA was sufficient for (50%) of cases. This corridor can be utilized in patients with stage IIIa in spite of extension of the lesion up to ITF. Our studies have confirmed the safety and efficacy of EETA approaches even in advanced cases.  Single EETA (type A) was sufficient in only 2/16 cases of stage II (12.5%) while the combined EETA were done for the rest of the cases 14/16 (87.5%).  
Conclusions: JNA may be successfully treated in most cases, even advanced ones, with expanded endonasal /endoscopy transpterygoid approaches after appropriate preoperative evaluation.