In recent years, with the maturity of nasal endoscopic skull base surgery technology and the deepening of the concept of minimally invasive surgery, diseases that originally required transcranial surgery can also be treated satisfactorily through nasal endoscopic minimally invasive surgery, and the anterior skull base and the pterionic saddle area are the areas that can be easily reached by endoscopic transcranial approach, our department has more clinical experience in the treatment of pituitary adenoma by endoscopic transcranial approach, and has also achieved good results. Figure 1 Pituitary adenoma Li Xuezhong, Department of Otolaryngology, Qilu Hospital, Shandong University Image 2: Pituitary adenoma Image 3: Chordoma Image 4 Primitive neuroectodermal tumor and so on recovery Nasal endoscopic skull base surgery has the following advantages compared with microsurgery: ① good visual effect; ② easy method; ③ can quickly reach the operation area; ④ short operation time; ⑤ less strain on brain tissue; ⑥ minimally invasive. With the help of different angle lenses, nasal endoscopy can enter the butterfly saddle to directly observe the tumor cavity after tumor removal, discover the tumor remaining in the dead corner of the microscopic field of view, directly understand the parsaddle structures, and even reach the small grooves and slope areas at the base of the anterior cranial fossa. The increasing maturity of nasal endoscopy technology, the promotion and application of wide-angle endoscopy, the application of high-resolution spiral CT and three-dimensional image reconstruction technology, the use of multifunctional power systems, and controlled intraoperative hypotension all provide important guarantees for nasal surgeons to perform anterior skull base surgery. Indications and contraindications: The indications for endoscopic skull base tumor surgery should be selected from two aspects: first, the patient’s physical condition must be suitable for surgery; the nature and scope of the lesion can be removed endoscopically. Secondly, from the physician’s side, the mastery of the indications is different because of the operator’s technical ability in nasal endoscopic skull base surgery and experience in dealing with different lesions. Contraindications include the following: (1) all contraindications to skull base surgery; (2) cases in which the nature and extent of the lesion cannot be completely resected endoscopically (this is a relative contraindication); (3) cases in which the approach is not suitable for intracranial and extracranial communicating tumors; (4) cases in which the lesion extensively invades the skull base and requires reconstruction of the skull base after resection. Endoscopic surgery for anterior skull base tumor is a better surgical approach with good selection of indications, making full use of the advantages of clear endoscopic vision, multi-angle display of the operative field, safety and minimally invasive.