Objective: The aim of this work is to study the indications, versatility, clinical and radiological results of the supraorbital 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 the approach.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. The data will be analyzed to evaluate the efficiency of the lateral supraorbital approach in comparison to the pterional approach.Results: In this study, 38 cases were operated upon, 19 by each of the supraorbital and pterional approach. There were a total of 20 males and 18 females, the ages of whom ranged from 10 months to 70 years. Various pathological lesions were treated by both approaches. Total removal was achieved in 10 (52.8%) cases of the supraorbital approach and 11(56%) cases of the pterional approach. In the supraorbital group excellent outcome was achieved in 5 (27%) cases. Good outcome was possible in 8 (42.1%) cases with 3 (15.8%) cases with poor outcome and 3 (15.8%) cases died. In the pterional group 6 (32.2%) cases had excellent outcome, 9 (47.3%) cases had good outcome and 3 (15.8%) cases had poor outcome. 1 (5.2%) case died.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 middle cranial fossa or below the level of the sphenoid ridge or posterior clinoid should not be approached by the supraorbital approach. Lesions extending into the retrosellar area may be difficult to manipulate. Lesions extending high up to the third ventricle may be approached by the trans-supraorbital approach