Transseptal transsphenoidal hypophysectomy has evolved into a low mortality/morbidity procedure in properly selected patients. Preoperative evaluation is becoming increasingly accurate with the rapid advances in computerized axial tomography. With the lowering of operative morbidity, indications for the transsphenoidal approaches to the sella are broadening. Caution must be used when approaching pituitary tumors with extensive suprasellar components by the transsphenoidal route.