Objective: The aim of this work is to study the indications, versatility, clinical and radiological results of the supraorbital approach,the orbitozygomatic approach in the treatment of different sellar and anterior cranial fossa lesions, and comparing these results with those obtained by the standard pterional approach. The results will hopefully be guidance to the advantages, disadvantages and limitations of both approaches.Methods: Pathological lesions involving the anterior cranial skull base, the sellar region, and the interpeduncular fossa are included as long as they could be approached by both approaches. Lesions include different tumors, developmental pathology, congenital lesions, and inflammatory lesions. The patients will be evaluated and investigated preoperatively. The operative procedure will be evaluated and analyzed. The patients will be followed for evaluation of extent of resection, postoperative complication and outcome. Results: In this study 40 cases were operated upon, 12by the supraorbital, 8 by the OZ and20 by the pterional approach. There were a total of 21 males and 19females, the ages of whom ranged from 10 months to 70 years. The extent of removal was found to be total removal in 7 (58.1%) cases in the supraorbital group and 12 (60%) cases in the pterional group, and 6(75%) cases in the orbitozygomatic group. Subtotal removal was 5 (41.5%) cases in the supraorbital group and 8 (40%) cases in the pterional group, and 2(25%) cases in the orbitozygomatic group. Regarding the outcome of the patients: in the lateral supraorbital group four (33.2%) cases had an excellent outcome, five (41.5%) cases had a good outcome, 2 (16.6%) had a poor outcome, and 2 (16.6%) died. In the pterional group 7 (35%) had excellent outcome, 9 (45%) had good outcome, 3 (15%) had poor outcome, and only one (5%) died. In the FOZ group 4 (50%) had excellent outcome, 3(37.5%) had good outcome and one case had poor outcome.Conclusion: The supraorbital approach is a safe approach that can be applied with good preoperative planning to lesions of the sellar area. Lesions extending into the 3rd ventricle are better approached by the OZ approach with better outcome.