This is a special patient who came to me years ago to see the film, when the patient was blind in the right eye for 10 days, and the enhanced MRI showed a skull base occupancy just below the optic cross. I changed to inform the patient of active surgery, using transnasal endoscopy to remove the skull base mass, which is minimally invasive, with fast postoperative recovery and avoiding the effects of craniotomy on brain tissue strain, and if the determination was made to admit on the first six days. On February 17, the patient’s family came to me again, and by this time the patient was already blind, with only light perception in the left eye, and visited Tiantan Hospital during this period. The cranial angiography showed that the lesion was changing rapidly and was closely related to the intracranial vessels. After careful arrangement, the patient underwent emergency surgery on the same day. On the 20th postoperative day, the left eye regained effective visual acuity of 0.1, and the right eye regained light perception and could move independently without assistance. Currently, the patient’s vision is recovering. Transnasal endoscopic skull base mass removal is minimally invasive, with few complications, short hospital stay and quick recovery. It includes 3 basic procedures: cerebrospinal fluid nasal leak repair, optic nerve canal decompression, and pituitary tumor resection. Optic nerve canal decompression has almost no effect on the optic nerve, and our patients with preoperative light perception have improvement after surgery, and tumor patients with normal preoperative vision still have normal visual acuity after optic nerve canal decompression, so optic nerve canal decompression is a basic procedure. Cranial base surgery is inevitable for cerebrospinal fluid nasal leakage, so cerebrospinal fluid nasal leakage repair is a necessary skill. Pituitary tumors are common in the skull base and therefore a routine procedure. We have accumulated more experience therefore extensive endoscopic skull base surgery is the inevitable trend and means to deal with skull base diseases nowadays and will definitely solve skull base masses for more patients.