The results of this study confirm the value, efficacy, and safety of transnasal endoscopic Sino-orbital surgery. The technique can achieve favorable removal and remission rates with very low morbidity. Endonasal Endoscopic sino-orbital surgery is a minimal invasive alternative to traditional transconjunctival, external frontoethmoidectomy, or lateral rhinotomy approaches to the orbital and sino-orbital lesions. The technique’s minimally invasive nature makes it very attractive for selected patients, as it has the potential to minimize the morbidity associated with other extensive approaches. Long-term control data and prospective analysis of surgical series are required to strengthen these conclusions and to extend the approach to totally remove orbital and sino-orbital lesions. The endoscopic endonasal approach for orbital and sino-orbital lesions is a minimally invasive surgery which offers a panoramic view of the orbital contents with increased illumination and magnifications. Such visualization provides a potential for more complete tumor removal with preservation of eye function and very low rate of complication. Finally we still need time to increase our skills and experience to master this approach and to improve our results. We feel that the advantages of the endoscopic approach will make this technique the favored approach for future treatment of skull base tumors.