<p>Minimally invasive method called trans nasal trans-sphenoidal (TNTS) endoscopic approach has been used to remove pituitary tumours. A single centre longitudinal study was aimed to assess the presentation, tumour extension and complication of pituitary tumours after TNTS endoscopic excision. Thirty-four patients who were diagnosed to have pituitary macroadenoma were selected by consecutive sampling. Patients undergoing TNTS surgery were evaluated and data was collected including- age, gender, clinical profile, details of imaging studies, pre-operative and post-operative complications and their management. A total of 34 patients included in the study (mean age 56 y). Among 34 patients, 31 (91%) had non -secretory and 3 (9%) had secretory adenomas. The predominant symptoms were visual disturbances (79.41%) and headache (64.70%) followed by infertility in 2 males and CSF rhinorrhoea in 1 patient. The tumour extension was to suprasellar (100%) region. MRI images showed 20.59%, 26.47% and 52.94% of pituitary tumours with cystic, semisolid and solid consistency respectively which was similar to pre-operative consistency. CSF leak was pre operatively found in 8 cases (23.53%) and bleeding in 1 case (2.94%) and no complications in 26 patients (76.47%). Non-secretory tumours and secretory tumours were more common, in males and females, respectively. Visual disturbances are the most common mode of presentation, followed by headache. Majority of tumour extension was to suprasellar region followed by to parasellar region. Post op complication was minimal or nil.</p>