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¹Ankara Üniversitesi Tıp Fakültesi, Nöroşirürji Anabilim Dalı, Ankara, Türkiye Pineal region surgery is challenging because of the deep location, complex anatomical relations and the vascular structures. The borders of the pineal region consist of the third ventricle posterior extension, the velum interpositum cistern and the quadrigeminal cistern. The region contains the pineal gland, posterior commissure, habenular commissure, and the superior and inferior colliculi of the tectal plate. It also contains important vascular structures such as intercerebellar veins, the great vein of Galen, the precentral cerebellar vein and the medial posterior choroidal artery. There are many surgical approaches for pineal tumors depending on the tumor location, extension or size. Supracerebellar infratentorial and occipital transtentorial approaches are most commonly preferred. It is important to know the anatomical structures and their variations for surgical planning and the prevention of complications. Anahtar Kelimeler : Pineal region, Pineal tumor, Microsurgical anatomy, Posterior third ventricle