Pituitary adenomas and craniopharyngiomas are the most common pathologies of sella that requires surgery. The other lesions for also which surgery is required are: Rathke’s cleft cysts, arachnoid cysts, tuberculosis, fungal infections, idiopathic granulomatous hypophysitis, and germinomas. The two evaluations discussed are: preoperative visual field and hormonal evaluation, and radiological evaluation. Trans-sphenoidal surgery topic describes about endoscopic trans-sphenoidal surgery, expanded endoscopic trans-sphenoidal surgery, and microscopic versus endoscopic pituitary surgery. The outcome of the trans-sphenoidal surgery mentions about the visuals, hormonal outcomes, atypical pituitary outcomes, outcomes in functional pituitary adenomas, Cushing’s disease, complications of trans-sphenoidal surgery, postoperative tumor bed hematoma, delayed hyponatremia, transcranial pituitary surgery, and hemorrhagic pituitary adenomas.