Objective <p>Surgical outcomes for the orbital-cavernous sinus schwannomas are limited. Therefore, the current study aims to present and evaluated surgical strategies and clinical outcomes in orbital-cavernous sinus schwannomas in our center.</p> Methods <p>A retrospective analysis was conducted in patients with orbital-cavernous sinus schwannomas who underwent surgery via the pterional approach combined with orbital osteotomy at our center between January 2016 and December 2024. Clinical data, extent of resection, postoperative neurological function and surgical complications were evaluated.</p> Results <p>A total of 32 patients were included in the current study. Gross total resection was achieved in 28 cases (87.50%) and subtotal resection was achieved in 4 cases (12.50%). After surgery, visual acuity was improved in 6 patients (18.75%), remained unchanged in 24 patients (75.00%), and worsened in 2 patients (6.25%). Proptosis improved in 32 patients (100%). Ptosis occurred in 11 patients, with 9 patients fully recovered during the follow-up and the remaining 2 patients experienced partial recovery. 2 patients experienced impaired ocular abduction, and were recovered within 3 months post-surgery.</p> Conclusion <p>Surgical intervention plays an important role in the treatment of orbital-cavernous sinus schwannomas. The pterional approach combined with orbital osteotomy achieved high resection rate, symptom relief, and a low incidence of complications.</p>