Combined operating microscope and telescopes associated with advanced surgical new instrumentation have been improved the outcome of skull base lesion surgeries, decreasing considerably the rate of morbidity. Since 1993, 53 patients with tumors of sellar region have been operated by transnasal approach at the ENT Center of Sao Paulo and Sao Paulo Skull Base Surgery Center, most of them by using just the endoscopic technique. The authors have used a transseptal or direct access to the sphenoid sinus. Most of the tumors have been completely removed using these techniques. This work reports the use of these techniques in selective pituitary gland tumors and emphasizes the advantages in using the endoscopes for these approaches.