Abstract： Objective To discuss the prevention and management of the complications of transsphenoidal operation for pituitary adenomas. Methods 412 cases underwent transsphenoidal surgery for pituitary adenomas were retrospectively reviewed and the rate of each postoperative complication was calculated. Results Surgical complications were found in 72 cases (17.5%), including 44 cases of insipidus(10.7% ), 17 anterior pituitary insufficiency(4.1%), 7 cerebrospinal fluid rhinorrhea(1.7%) ; 4 visual deterioration(1.0%), 6 abducens nerve paralysis(1.5%), 3 nasal cavity hemorrhage(0.7%), 2 hemorrhage during operation (0.5%) and 1 cerebral infarction (0. 3%). There was no death case. Conclusions The complications are considered to be closely correlated with operative procedure. The familiarity with the regional anatomy and skillful microsurgical techniques could lower the incidence of complications.