Surgery for pituitary tumours at our institution was performed by rhinosurgical route by combined procedure by otolaryngologist and neurosurgeons. A retrospective review of case records of patients who had endonasal endoscopic transsphenoidal approach for pituitary tumours from September 1998 to December 2004 was performed. A total of 81 transphenoidal surgeries were performed during this study period. Only 68 case records with adequate information were available for review, 56 patients were included in the study and 12 were excluded. There were 24 males (42%) and 32 females (58%). The ethnic distribution were 29 Malays, 24 Chinese, 2 Indians and 1 other. The age ranged from 16 years to 76 years, with a mean of 46 years. The majority of our patients presented with visual symptoms (38), headache (28), menstrual cycle disturbance or impotence (14) and acromegalic features (16). Fourty patients had macroadenoma (71%) and 16 had microadenomas (29%). Thirtysix patients out of 40 macro-adenoma had suprasellar extensions (90%). Only 11 patients had lumbar drain inserted prior to commencement of the surgery and the majority of these were macroadenomas. The common complications encountered were diabetes insipidus (4), cerebrospinal fluid leak (2), meningitis (3), epistaxis (2), septal perforation (2), intercavernous sinus haemorrhage (3) and anterior pituitary insufficiency (2). Our study reveals that endonasal transsphenoidal approach is a safe and effective method of management of pituitary adenomas.