Background: Endoscopic transsphenoidal surgery had been shown to be a safe and effective treatment option for patients with pituitary tumors, but there has been no study exploring patients' perceptions before and after this surgery. Objective: The authors in this study aim to explore patients' perceptions on endoscopic transsphenoidal surgery. Methods: Using a qualitative research methodology, two semistructured interviews were conducted with 30 participants. These participants were adults older than 18 years who underwent endoscopic endonasal transsphenoidal surgery for the resection of a pituitary tumor between December 2008 and June 2011. The open-ended interviews were audiotaped and transcribed and the resulting data was analyzed using a modified thematic analysis. Results: The following seven overarching themes were identified from the data: (1) Patients had a positive surgical experience; (2) patients were satisfied with the results of the procedure; (3) patients were initially surprised that neurosurgery could be performed endonasally; (4) patients expected a cure and to feel better after the surgery; (5) many patients feared that something might go wrong during the surgery; (6) patients were psychologically prepared for the surgery; (7)most patients reported receiving adequate preoperative and postoperative information. Conclusions: This is the first qualitative study reporting on patients' perceptions before and after an endoscopic endonasal transsphenoidal pituitary surgery, which is increasingly used as a standard surgical approach for patients with pituitary tumors. Patients report a positive perception and general satisfaction with the endoscopic endonasal transsphenoidal surgical experience, both preoperatively and postoperatively. However, there is still room for improvement in postsurgical care. Overall, patients' perceptions can help improve the delivery of comprehensive care to future patients undergoing pituitary tumor surgery.