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Pituitary is the central of human endocrine system. The pituitary operation has a high danger because of many factors, including its deep location in the middle of skull base, surrounded by lots of important nerves and vessels, etc. Pituitary adenoma is one of the most common intracranial tumors, counts 10% of all, and this number tends to aggravate year and year. As the growing of the tumor, it not only can break the balance of endocrine system, but also can invasive its surrounding structures causing some significant neurological impairment. As the development of microneurosurgery, navigation and neuroendoscopic techniques, pituitary surgery has a deep improvement in the choice of approaches and usage of new techniques during the operation. Microinvasive techniques such as transnasal sphenoidal approach and neuroendoscopic techniques are more and more used in pituitary adenomas operations. As one kind of the most common tumors, pituitary adenoma removal can be carried out in all suitable hospital. But there still are some gaps with the international level in the aspects of our operation conceptions and techniques. Peking union medical college hospital neurosurgery pituitary adenomas management center has carried out many studies in the management of pituitary adenomas which cost several generations' efforts. This atlas consists of two parts. The first part is the different approaches and related neurological anatomy for pituitary surgery. We wrote this part by a process of different approaches. The related microanatomy and live operation pictures are listed out, from the body position and skin incision to the neurological structures and vessels during the operation. The second part is the typical pituitary adenomas cases in Peking union medical college hospital, including the image materials before and after the operation, some pictures during the operation and some block diagrams.