The Prolactinoma is the most common pituitary tumor, accounting for 30% of all pituitary adenomas encountered in clinical practice. From a practical standpoint, Prolactinomas can be viewed as having one of the following biologic profiles : Microadenomas, Macroadenoma and Aggressive phenotype.The clinical features of prolactin secreting pituitary adenomas are related to the endocinological consequences of sustained hyperprolactinemia and the neurological sequelae of an expansible sellar mass. In females, Menstrual dysfunction, and Galactorrhea. In Males and post menopausal females the presentation is mainly due to mass effect, loss of libido and erectile dysfunction occur in the former.40 cases with proloactin-secreting adenome, (Prolactinoma) were managed as follow, 6 cases with micro adenomas underwent surgery via. trans-sphenoidal approach 2 cases presented with apoplexy failed to improve on medical treatment & underwent surgery.The Remaining 32 cases were subjected to medical treatment using dopamine agonists, six was failed to respond or were intolerant &underwent surgery. Twenty six cases improved on medical treatment. First line of therapy with dopamine agonists is effective in normalizing hyperprolactinemia and shrinking tumour size. Resection is indicated in patients who can't tolerate medical therapy or in whom it fails. Surgery should also be considered in patients with micro prolactinomas when complete tumor removal with biochemical cure in an expected outcome. Apoplexy still a neurosurgical emergency needs urgent trans-sphenoidal decompression.