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¹Bursa Uludağ Üniversitesi Tıp Fakültesi, Beyin ve Sinir Cerrahisi Anabilim Dalı, Görükle, Bursa, Türkiye The aim of presigmoid approaches, one of the most complicated approaches in neurosurgery, is reaching the posterior cranial fossa after partial or total petrosectomy through the presigmoid area. Presigmoid approaches are anterior extensions of the lateral suboccipital approaches. It is possible to particularly expose the cerebellopontine angle and pons and also to reach some of the posterior circulation aneurysms that are hard to reach via presigmoid approaches and its modifications through the transpetrosal route, which were essentially defined to reach the pathologies of the ventral brainstem and clival region. In this article, the anatomical basis of the surgical techniques, indications and complications of the retrolabyrinthine approach, translabyrinthine approach and transcochlear approach, the 3 variations of the presigmoid approach that each are progressive steps of petrosectomy, will be discussed in the light of the current literature. Anahtar Kelimeler : Presigmoid, Retrolabyrinthine, Translabyrinthine, Transcochlear