Abstract: Objective To explore the inducement and management of bleeding in transsphenoidal approach in patients with pituitary adenoma. Methods All 853 cases were enrolled in this study and 6 of which present with the complication of bleeding, the inducement and management of bleeding were analyzed retrospectively and the literature correlated were reviewed. Results 6 of which present with the complication of bleeding, among which 2 cases of nasal bleeding,2 cases of intra - sellar bleeding, 1 case of supra - sellar bleeding, 1 case of incorrelated bleeding. No death occurred. Conclusions The rate of bleeding can be diminished by strictly complying of indication, comprehension of the anatomy correlated and character of the adenoma,improvement of experience in diagnosis and surgical technique. Find the inducement of bleeding and the vessels correspondent to once the bleeding occurred, try best to avoid the impairment resulting from inappropriate handling.