Abstract: Objective : To summarize our experience on the enlarging modified pterional keyhole approach for removing the tumors in the middle skull base and seller region. Methods : One cavernous hemangioma and one middle skull base meningioma were removed via zygomatic pterional keyhole approach. The others were removed via orbitozygomatic approach. Results : Subtotal resection was performed for two cases of cavernous hemangiomas. Total resection of the tumors was achieved in the other cases. There was no death associated with operation. 5 cases with visual disturbance improved after surgery and one case worsened. The cases with hemiparesis improved after surgery. Conclusion:By using this approach, the tumors could be displayed maximally under microscope, the rate of total resection is higher than by others and the postoperative complication were rare. This approach is the ideal method for surgery of the tumors in the middle skull base and seller region.