Vacuolation saddle is a series of clinical manifestations that occur when the subarachnoid space protrudes into the saddle due to saddle septal defect or pituitary atrophy, resulting in saddle enlargement and pituitary gland compression. It can be divided into two categories: secondary vacuolated saddle syndrome, which occurs in the saddle, or after surgery or radiation treatment, and primary vacuolated saddle syndrome, which is not caused by surgery or radiation treatment and has no obvious cause. Headache is the most common symptom, and a few patients may have visual acuity loss and visual field defects, and a few patients may have benign intracranial pressure increase with optic nerve papillary edema, and cerebrospinal fluid pressure increase. Vacuolant saddle syndrome is generally considered to require no treatment if the symptoms are mild, and surgical treatment may be used if there are significant symptoms.