OBJECTIVE: To investigate the experience of using a high-field intensity intraoperative MRI system in combination with an intraoperative navigation system in transsphenoidal pituitary adenoma surgery. Methods From March to July 2011, a total of 32 patients with pituitary adenomas (from 24 to 72 years old, mean age 48.20±6.50 years old) were treated with trans-pituitary sinus approach surgery. The tumor size ranged from 0.9 to 6.2 cm, with a mean of 2.25 ± 0.55 cm. The GE 1.5T high field intensity intraoperative MRI system and BrainLabVV-SKY neuronavigation system were used intraoperatively. Results: Among the 32 cases of pituitary adenomas treated surgically, intraoperative MRI scans revealed residual tumors in 20 cases, including 5 cases of giant pituitary adenomas, which were not completely resected because the tumors encircled the internal carotid artery and invaded the cavernous sinus; the remaining 15 cases were further resected and confirmed to be completely resected by intraoperative MRI scans. Conclusion: The high field intensity intraoperative MRI system can obtain high quality images, which provide an objective basis for preoperative navigation planning and real-time determination of the extent of pituitary adenoma resection during surgery, reduce serious intraoperative complications, and improve the rate of complete resection of pituitary adenomas.