Two hundred and seventy eight cases of transseptal transsphenoidal approach to pituitary tumor and other sellar lesions including thirteen cases of external rhinoplasty approach during a period of 14 years between June, 1977 and June, 1991 were analysed. The results were as follows : 1) Male to female ratio was 1 : 1.26. 2) Two hundred and sixty five cases were pituitary adenomas. 3) The chief complaints were visual disturbance(33%), headache(21%), amenorrhea(19%), acromegaly(12%) and galactorrhea(4%) in order of frequencies. 4) Pneumatization of the sphenoid sinus was classified as sellar(69%), presellar(20%) and unclassified(11%). 5) Destruction of the sellar floor was observed radiologically in 88(32%), thickening(>2mm) in 22(8%) and thining in 34(12%). 6) Of 136 cases with preoperative visual disturbance, 82(60%) were improved and 8(6%) were aggravated after operation. 7) Postoperative complications were transient diabetes insipidus(17%), CSF rhinorrhea(7%), panhypopituitarism(5%), meningitis(4%), and septal perforation(2%). 8) Among 13 cases of external rhinoplasty approach, 12 were diagnosed as pituitary adenoma and one was sphenoid sinus tumor. Postoperative nasal contours in external rhinoplasty approach showed cosmetically better results than those in conventional sublabial approach.