In this present study, we reviewed our management of seven patients by an extended endoscopic endonasal transsphenoidal approach to resect tuberculum sellae meningiomas. All surgery was performed using pure endoscopy and a neuronavigation system. In six patients, total resection of the tumor was accomplished; one patient had subtotal tumor removal. Post-operatively, visual function was improved in six patients, and was unchanged in one patient. There was asymptomatic tumor recurrence on MRI during the follow-up period in the patient in whom a subtotal resection had been performed. This preliminary report suggests that an extended endoscopic endonasal transsphenoidal approach is an effective, minimally invasive approach for small and medium-sized tuberculum sellae meningiomas located in the midline. However, this approach should be limited to an experienced and coordinated endoneurosurgical team.