Tumors of the pineal region include pineal germ cell tumor, pineal teratoma, pineal meningioma, cavernous hemangioma, pineal astrocytoma, epidermoid cyst, dermatomatous cyst, metastasis, and some rare malignant tumors, and the prognosis varies greatly depending on the nature of the tumor. For example, pineal meningioma, cavernous hemangioma, benign teratoma, epidermoid cyst, and dermatomatous cyst can be cured in most patients with surgical resection. However, the prognosis of some malignant tumors is poor, and most patients survive for less than 5 years. Currently, the common surgical methods include supratentorial approach via occipital perineural approach, and infratentorial approach with supratentorial subcapsular approach. No matter which method is used, it requires skilled microscopic technique, clear local microscopic anatomy and sufficient clinical experience to reach the area and remove the tumor satisfactorily. As long as the surgeon has enough experience, the surgical risk of tumor in this area can still be accepted by the surgeon and the patient’s family. For the patient, it is important not to think that once the tumor grows in this area is incurable; for the surgeon, he or she must have dexterous hands when performing surgery in this area and fully respect the local neurovascular.