Craniopharyngioma is one of the most common lesions of the saddle area in children and is a benign tumor of embryonic remnant tissue. They occur in preschool children, with the majority starting under the age of 15. The clinical presentation varies depending on the extent of the lesion. The lesion is usually located in the suprasellar region, and when it is large, it often protrudes into the third ventricle and causes obstructive hydrocephalus, so some patients start with headache and vomiting. Most of the children have different degrees of decreased adenopituitary or pituitary stalk function, such as depression, loss of appetite, thirst, excessive drinking and polyuria. Some children also present with loss of vision and convulsions. Preoperative cranial imaging such as CT or MRI is one of the essential tests. The preoperative evaluation also includes adenopituitary function, access, and electrolytes. Preoperative adjustment of the child’s general condition, including nutritional status, is essential to improve the success of surgery. Because craniopharyngioma is a benign tumor, treatment is mainly based on microsurgery. It is generally believed that total resection should be achieved at the first surgery, as it will be very difficult to operate again after recurrence. Postoperative decision of whole brain radiation therapy or stereotactic surgery is based on pathology and cranial imaging review.