This highly complex and specific field of neurosurgery involves special approaches to tumours and other pathologies in the skull base area. A surgical procedure taking a path outside the brain tissue itself is typical, with the need for a greater bone invasion, but a lower risk of damaging the nerve structure. Operations are often conducted through a highly targeted approach on a small scale (“keyhole surgery”). The quality of control of operations in this field is at the very peak of neurosurgery. The nature of operated problems demands maximum teamwork and cooperation (neuromonitoring, detailed radiological display, advanced instrumentation, high quality neuro-anaesthesia and subsequent intensive care). At present our department has some of the best conditions for this type of operation in the Czech Republic, both in terms of equipment and personnel.