Background: The combination of microscopic and endoscopic technique has showning significant advantages in the management of various cerebellopontine angle (CPA) lesions through different approaches. Endoscopic-assisted techniques have frequently been applied to cerebellopontine angle (CPA) surgery in the context of minimally invasive craniotomies, which increase the extent of tumor resection, minimize complications, and preserve the function of the delicate CPA structures. Objective: To assess the outcome of microscopic and combined microscopic with endoscopic technique as minimally invasive approach in Al Azhar experience. Patients and Method: twenty-two consecutive patients proved to have CPA masses were treated with microscopic and combined microscopic with endoscopic technique between September 2016 and December 2019 at the Neurosurgery Department, Al-Azhar University Hospitals. All patients included in this study have CPA masses. The reliability of the extent of microscopic removal was evaluated with endoscopic exploration. Additional resection was performed with both microscopic and the combined microscopic-endoscopic technique. Endoscopically verified total resection was validated by postoperative MRI. The function of the cranial nerves was evaluated to assess the impact of the combined technique on their function. Results: The mean age of patients in this study was ~ 43 years. All cases are clinically elevated by Glasgow Outcome Score (GOS) early after wakeup of anesthesia and late after 24 hrs. The favorable outcome achieved early in 18 patients (81.82%) and late in 19 patients (86.36%), while unfavorable outcome achieved early in 4 patients (18.18%) with improvement of one case later on and the achieved unfavorable outcome became 3 patients (13.64%). In correlation of pathology to GOS; schwannoma cases show 9 favorable outcome and only one unfavorably outcome, all 8 epidermoid cases were favorably outcome, while meningioma cases show 1 favorably and 2 unfavorably outcome. Regarding 7th cranial nerve injury; inadvertent injury occurred in one meningioma patient. Three patients experienced transient deterioration of their facial nerve functions in the postoperative period and improved by the end of the first month postoperative. Conclusion: This method provides simultaneous microscopic and endoscopic visualization and dissection techniques through skull-base approaches to CPA tumors. It overcomes some of the shortcomings of endoscopic-assisted surgery, further extends the surgical field, and increases the radicality of tumor resection with good functional outcomes.