The pineal region contains a large number of important structures and blood vessels, and its location is deep, which makes it difficult to operate. On the basis of the classical surgical approach, we have improved it by applying modern microscopic neurosurgical techniques to make a linear scalp incision in the occipital region, and combined with the patient’s position, we applied gravity-assisted retraction to achieve the goal of fully exposing the pineal region for resection of the lesion. From March 2009 to March 2014, 82 cases of children with pineal region tumors admitted to the pediatric neurosurgery group of Tianjin Huanhu Hospital were operated with small incisions. Skin incision: 5-7 cm in length, 5 cm for younger children with thinner scalp; 7 cm for older children with thicker scalp. maximum lesion resection was achieved with minimum damage. The surgical effect is good.