Abstract: Objective To compare and evaluate several operative approaches for microsurgical treatment of craniopharyngiomas.Method Of 32 patients,14 cases were operated via pterional approach,3 via subfrontal approach,5 via transcortical-transforaminal approach combied with subfrontal approach,6 via transcallosal-interseptal-interforniceal approach,2 via transcallosal-interseptal-interforniceal approach combined with subfrontal approach,2 via transfrontal interhemispheric approach.Results Of 32 patients,total removal of tumor was achieved in 26 cases,4 subtotal removal,and 2 partical removal.Conclusions Selection of a suitable operative approach on the basis of different types of tumor is the key for total removal of craniopharyngioma.For Samii types,gradeⅠ~Ⅱcan be operated via subfrontal and pterional approach;grade Ⅲ~Ⅴ (without expansion) can be operated via transcallosal-interseptalinterforniceal approach;grade Ⅲ~Ⅴ(with expansion) can be removed by combined approaches,such as transcallosal- interseptal- interforniceal approach combined with subfrontal approach,transcorticaltransforaminal approach combied with subfrontal approach or transfrontal interhemispheric approach.