Pituitary adenoma is a relatively common intracranial tumor with a high incidence, accounting for 8-15% of intracranial tumors and ranking 3rd. Surgery is the preferred treatment option for this disease. There are two surgical routes for pituitary adenoma: transfrontal craniotomy and transsphenoidal approach. The craniotomy is very traumatic, and the patient has many complications and fears after surgery. The transsphenoidal approach includes submucosal nasal septal approach via orbital sieve – maxillary sinus – pterygoid sinus and sublabial nasal septal disc sinus approach. With the change in endoscopic surgical techniques and surgical perspectives, pituitary adenoma surgery has evolved towards low invasive precision. It is a new type of surgery based on the traditional transsphenoidal surgery. Using the modern nasal endoscopic surgery technique, the pituitary adenoma is exposed through the nasal cavity by directly revealing the pterygoid sinus, and the tumor is directly removed under the surveillance system, which can clearly reveal the tumor and the normal gland, and the tumor can be completely removed to achieve the radical effect. The operation is precise, less traumatic, and has a quick recovery (patients can get out of bed 12 hours after surgery and be discharged one week after surgery). 95% of pituitary adenoma patients can be operated under the nasal endoscope through the butterfly approach.