Pituitary macroadenomas are generally surgically treated by transcranial or transesphenoidal approach using an surgical microscope. Recently, the endoscope has been introduced in pituitary surgery instead of microscope. Both, endoscopic and microscopic approaches allow a secure and efective tumoral resection, however the endoscopic approach has certain advantages such a better visualization of surgical field  and preservation of sinus nasal funcion, shorter hospital stay, better patient confort and lower rate of complications. We presented the first report in Peru of endoscopic Endonasal Approach, carried out in the Cayetano Heredia Hospital in december 2008.