The results of this study confirm the value, efficacy, and safety of endoscopic pituitary surgery. The technique can achieve favorable removal and remission rates with very low morbidity. Endoscopic cranial base surgery is a minimal invasive alternative to traditional transsphenoidal, transcranial, or transfacial approaches to the cranial base. The main indication is for centrally located lesions or as an adjunct to craniotomy for more extensive tumors. 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 skull base tumors. The endoscopic endonasal trans-sphenoidal approach for skull base tumors is a minimally invasive surgery preserving the nasal structures thus facilitating faster postoperative recovery. It offers a panoramic view of the sphenoid sinus with visualization of the corners of the sellar and suprasellar structures with increased illumination and magnifications. Such visualization provides a potential for more complete tumor removal with preservation of pituitary 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 regarding total excision of skull base tumors other than pituitary adenoma. We feel that the advantages of the endoscopic approach will make this technique the favored approach for future treatment of skull base tumors.