Within 3 years, 34 patients with lesions of the posterior part of the orbit, the optic canal, and the superior orbital fissure were operated using different surgical approaches. The results on the functional and cosmetic outcomes were compiled. The pterional approach was shown to be the most useful one. It can be used in intradural as well as in extradural and combined operations. It allows an excellent view of basal cerebral structures as well as the frontal base of the skull. The operative results are dependent on the type and the location of the lesion, and, especially in meningiomas, on their relationship to the cavernous sinus.