Introduction: In the past, intra-cranial surgeries need external incision, blood loss, and injury to vital structures of the brain parenchyma, which finally leads most of the time to mortality and morbidity. As time passed, a major breakthrough has come in this keyhole surgeries concept, thus reducing mortality and morbidity. One such is the keyhole Endoscopic endonasal trans spherical pituitary surgery. The conventional approach to pituitary surgeries has many drawbacks. How meticulous is the surgeon? Methodology: Patients diagnosed with symptomatic pituitary adenomas in all age groups were taken into the study from the period Statistical evaluation was done by taking different parameters like age, sex, symptoms, and complications. Mortality and morbidity rates were evaluated. Results: Post of recovery, recurrences, and outcomes were evaluated and proved to be a superior approach to conventional. Conclusion: Endoscopic endonasal trans-sphenoidal pituitary surgeries proved to be the best approach when compared to conventional open surgeries, which result in high mortality and morbidity rates. Functional outcomes are superior with endoscopic surgeries.