Pituitary ependymomas are incidental findings of pituitary tumors without clinical endocrine symptoms or occupying effects. The diagnosis relies on endocrine screening and visual field examination, among others. Incidental microadenomas are less likely to increase in size, whereas macroadenomas have a tendency to increase in size. Patients in this category need regular follow-up and should be treated surgically if the tumor continues to increase in size.