Abstract: Objective：To compare the clinical efficacy and safety of microscopic and endoscopic single nostril transsphenoidal approach pituitary adenoma resection. Methods： We selected 162 patients with pituitary tumors from December 2009 to December 2016 in our hospital for treatment， the patients were divided into two groups： the control group 81 cases were treated by microscopic single nostril transsphenoidal approach pituitary tumor resection， and experimental group of 81 cases underwent endoscopic single nostril transsphenoidal approach pituitary tumor resection； observation of two groups of patients with bleeding in the tumor resection， tumor excision and surgical complications， analysis of the symptoms of patients with postoperative recovery and hormone recovery situation. Results： The amount of bleeding during operation， postoperative complications， postoperative hospitalization time and operation time in the control group compared with the experimental group were different(P＜0.05). Hormone level recovery rate and the clinical remission rate of perioperative period and the prognosis in the control group compared with the experimental group were different(P＜0.05). In the control group， 3 cases of infection， 7 cases of diabetes insipidus， 2 cases of hemorrhage， 6 cases of pituitary low power， 10 cases of cerebrospinal fluid rhinorrhea and 5 cases of nasal septum perforation； in the experimental group， 0 case of infection， 3 cases of diabetes insipidus， 0 case of hemorrhage， 0 case of pituitary low power， 2 cases of cerebrospinal fluid rhinorrhea and 1 case of nasal septum perforation. Complication of experimental group was better than control group， the difference between the two groups was statistically significant (P＜0.05). Conclusion： Endoscopic surgery is minimally invasive， process more secure， with shorter operation time and hospitalization time， lower the incidence of diseases and postoperative reaction is lighter. Neuroendoscopic surgery has obvious advantages in improving hormone level and the tumor resection and tumor excision rate.