ObjectiveTo explore the surgical approach selection and microsurgical techniques of microsurgical resection of tuberculum sellae meningiomas.Methods46 cases of tuberculum sellae meningiomas were retrospectively analyzed.All the cases were performed by microsurgery.19 cases via subfrontal approach, 14 cases via pterion approach, 7 cases via foreheadpterion combined approach, and 6 cases via supraorbital keyhole approach.ResultsA total resection(Simpson gradeⅠandⅡ) was conducted in 42 patients, and a subtotal resection(Simpson grade Ⅲ) in 4 patients.Visual acuity was improved in 39 patients, unchanged in 5 patients and worse in 2 patients.ConclusionSuitable approach selection and skilled microsurgical techniques can guarantee the surgical therapeutic effects.