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İstanbul Üniversitesi, Cerrahpaşa Tıp Fakültesi, Nöroşirürji Anabilim Dalı, İstanbul, Türkiye Surgical access to lateral and third ventricles are challenging due to their deep location, their close proximity to important vascular structures, and relation to many functional white matter tracts. By reviewing the microsurgical anatomy, anatomofunctional consideration of the region, and the pathological processes of the lateral and third ventricles, this chapter focuses on possible surgical routes to enable obtaining the widest optimal surgical views, while minimizing the unintended neurological damage secondary to the necessary steps of the surgical approaches. In this context, we discuss the anterior interhemispheric transcallosal and anterior transcortical approaches to lesions located in the frontal horn of lateral ventricles; the anterior interhemispheric transcallosal approach to the body of the lateral ventricles; the distal sylvian, posterior transcortical, posterior transcallosal, interhemispheric transprecuneus and supracerebellar transtentorial approaches to the atrium; the transtemporal, subtemporal and transsylvian transamygdalar approaches to the temporal horn; and the transforaminal, interforniceal, transchoroidal transvelum interpositum and subchoroidal transvelum interpositum approaches to the third ventricle. Anahtar Kelimeler : Surgical approaches, Lateral ventricle, Third ventricle