The results of a retrospective study of 21 patients undergoing surgery with pterional approach to pituitary adenomas are reported. There were 7 females, and 14 males, between 20 to 68 (average 43.5) years of age. According to adenoma extension 6 patients were with type III-A (suprasellar-suprachiasmatic), 4 with type III-B (suprasellar-retrosellar), 6 with type III-C (parasellar-cavernous), and 5 with type III-D (paninvasive). According to adenoma size there was 1 patient with small (5 mm-2 cm), 11 with moderate (2-4 cm), 4 with large (4-6 cm), and 5 patients with paninvasive adenomas. Histopathological examination showed null cell in 11, growth-cell in 6, prolactin-cell in 1, and plurihormonal adenomas in 3 cases. Two patients have died. The cause of death was hypothalamic lesion or cerebral infarct.