Tuberculum sellae meningiomas represent 5 to 10% of intracranial tumors. These tumors are a distinct clinical entity, displacing the optic pathways upward and laterally and, thus, occupying a subchiasmal location. Therefore, they must be distinguished from tumors arising from different sites, such as the olfactory groove, sphenoid planum, and anterior clinoid process, which are often considered as suprasellar tumors. The difficulty in the surgical treatment of these tumors is explained by the abundance of important neurovascular structures that surround them. During the past few years, the transsphenoidal approach for removal of extrasellar lesions has been reported with increased frequency. Therefore, tumors located in the anterior cranial base that were once thought to be accessible only from the transcranial approaches are now being approached through a so-called ?extended transsphenoidal route,? a modification of the routine standard transsphenoidal exposure, either sublabial or endonasal, microscopic, or endoscopic. Figure 1 demonstrates RMI before and after the surgery (Video Clip 1).