The pineal gland is located deep in the central part of the brain, posterior to the third ventricle. The surrounding blood vessels and nerves are dense, and the risk of surgery is high. The surgical approach is usually taken to the suboccipital supratentorial approach because it is the closest to the pineal region. The patient is placed in a prone position, the scalp is incised, the occipital bone flap is milled, the dura is cut, the occipital lobe is retracted, and the cerebellar curtain is cut, and the pineal gland is explored in the deep brain. The large cerebral vein and the internal cerebral vein should be protected during surgery to prevent hemorrhage and life-threatening injuries.