Prolactin (PRL) pituitary microadenoma is a pituitary adenoma <1CM in diameter that secretes mainly prolactin. With increased awareness of the disease and the promotion of blood PRL testing and magnetic resonance imaging (MRI) and enhancement (preferably enhanced dynamic scanning) of the saddle area, more and more PRL pituitary microadenomas are being detected, however, this disease is a neurosurgical category and is often misdiagnosed by non-specialists. A definitive diagnosis of PRL pituitary microadenoma requires a combination of clinical symptoms (menopause, infertility symptoms), laboratory parameters (blood PRL), and imaging data (MRI and enhancement of the saddle area). If there are only clinical symptoms, but the laboratory indicators (blood PRL) and imaging data do not support it, it is often caused by gynecological diseases; if there are only laboratory indicators (blood PRL), but the clinical symptoms and imaging data do not support it, it is often caused by the influence of medication, such as chlorpromazine and methotrexate; the blood PRL value will return to normal after stopping the medication. Generally, PRL values >50ng/ml are suspected of having a prolactin pituitary adenoma; >100ng/ml are highly suspected of having a prolactin pituitary adenoma; >200ng/ml are basically certain of having a prolactin pituitary adenoma. There are also no clinical symptoms and laboratory indicators (blood PRL) support, imaging saddle area magnetic resonance imaging (MRI) pituitary enlargement, seen in hypothyroidism and physiological enlargement in children, need to determine the level of thyroxine. Therefore, a comprehensive and integrated consideration is needed to clarify the diagnosis and prevent misdiagnosis. Treatment includes medication (bromocriptan), surgery, and gamma knife. Drugs are often the treatment of choice, especially for women who have not had children, but drugs have symptoms of gastrointestinal irritation, and vitamin B can be taken to slow down the symptoms. The medication should be taken in small doses (half a capsule) and gradually increased, and the blood PRL should be checked every 3-4 weeks, and the dosage should be adjusted according to the disappearance of clinical symptoms and the normal blood PRL value. After pregnancy is confirmed, the drug should be stopped. If miscarriage occurs, the drug should still be taken for 2-3 months after the next pregnancy. Patients with severe digestive symptoms or drug insensitivity may opt for surgical treatment, which has a higher possibility of radical cure and is currently safe and effective with transnasal butterfly microscopic surgery. For those who are afraid of surgery or have contraindications, gamma knife treatment is an option. At least 6 months to take effect, most do not achieve a radical effect, but can reduce the drug dose, but also reduce the gastrointestinal symptoms. Gamma knife treatment is not recommended for those with fertility requirements. Surgery and Gamma Knife treatment patients need to determine the level of corticosteroids and thyroxine and sex hormones, and if there is low, oral supplementation should be taken.