Objective:To summarize our experiment in microsurgical removal of tuberculum sellae meningioma via transcranial approach.Methods: The clinical data of 45 patients with tuberculum sellae meningioma, who were treated by microsurgical resection via different transcranial approaches during Jan. 2003 to May 2009, were retrospectively analyzed. And the factors influencing the prognoses were also analyzed.Results: Eight patients had Simpon grade Ⅰresection and the others had grade Ⅱresection. Postoperatively, the visual damage and optic field defect were improved in 28 cases, remained unchanged in 15 cases, and deteriorated in 2 cases. The vision recovery was not satisfactory in patients who had obvious vision decrease before a complicated surgical removal of tumors.Conclusion: Personalized surgical plan should be selected for resection of tuberculum sellae meningioma according to the size and growth direction of tumors; special attention should be paid to protect the important structures of the sellar region. Improvement of the surgical technique is the key to a better prognosis after resection of tumors.