Pineal cyst surgery is risky and traumatic because the pineal region belongs to the deep central location of the brain, and this area is densely packed with blood vessels, nerves and important brain tissues, so surgery may result in serious complications, causing the patient to have impaired eye movement, diplopia, intraoperative hemorrhage, postoperative hemiplegia or even coma and death. Pineal cysts are not easily operated on unless the cysts cause obstructive hydrocephalus, resulting in headache, nausea, vomiting or even coma in patients. Surgery is usually performed by craniotomy and cystectomy via the inferior occipital cerebellar curtain approach, with care taken to protect important structures such as the large cerebral veins around the cyst.