Abstract： Objective To explore the clinical features,surgical approaches and postoperative outcomes of craniopharyngiomas.Methods A series of 169 consecutive cases of craniopharyngiomas undergoing microsurgical resection via various approaches at our hospital were retrospectively analyzed.There were 102 males and 67 females with a mean age of 34.1 (3-74) years.The operations were performed via unilateral subfrontal (n =11),frontopterional (n =69),anterior interhemispheric (n =57),transcallosal (n =9),transsphenoidal (n =14),transcortical (n =2),transventricular-foramen with neuroendoscope (n =5) and combined (n =2).Postoperative measures included the managements of blood sodium disorder and diabetes insipidus.During follow-ups,they were monitored for residual or recurrent tumor by postoperative contrast magnetic resonance imaging (MRI) every 1-3 months.Results The removals of lesions were total (n =124,73.4％),subtotal (n =32,18.9％) and partial (n =13,7.7％).And 104 cases had an intact preservation of pituitary stalk and stalk was partially preserved in 21 patients.Visual improvement (n =49) and deterioration (n =21) were achieved.The major postoperative complications included diabetes insipidus (n =101) and electrolyte disorder (n =89).And 26 patients had recurrence during a follow-up period of 26.1 (3-66) months.Conclusion Selection of appropriate approaches according to morphological characteristics is essential for successful microsurgery of craniopharyngiomas.