Abstract: Objective: To introduce the experience in the microsurgical removal of giant pituitary adenomas through three approaches.Methods: Thirty-six cases of giant pituitary adenomas were treated by microsurgery.The giant pituitary adenomas were excised through subfrontal approach in 22 cases,pterion approach in 13 cases,combined approach in 1 case and nasal cavity-sphenoidal sinus approach in 1 case.Results: Of the 36 patients,26 achieved total removal of the tumors,8 subtotal removal and 2 part removal.After the operation,the eyesight was obviously improved in 30 cases.Complications occurred in 10 cases,among whom,4 suffered from diabetes insipidus,2 suffered from bleeding in stomach and the right eyesight in 4 cases got worse,but after 10 days,the eyesight revived.One case died.The fellow-up of 6 months showed that the symptoms were improved in 35 cases.Conclusions: Microsurgery by the subfrontal,pterional or combined approach is effective for the treatment of giant pituitary adenomas with a high total removal rate.