Abstract: Objective To investigate the effect of surgical strategy and therapy and the factors affecting tumor recurrence in craniopharyngioma.Methods Retrospective analysis clinical data of 375 surgical treatment cases with craniopharyngioma.Evaluate the surgical modalities，techniques and therapeutic effects of different types of craniopharyngioma.Results The growth mode and location of tumor：218 cases above diaphragma sellae，43 cases in diaphragma sellae and 114 cases in three ventricles.Surgical approach selection：classic pterodactory or subordinate approach in 288 cases，transsphenoidal approach in 46 cases，longitudinal corpus callosum approach in 23 cases，cortical ventricular approach in 17 cases，combined approach in 1 cases.Tumors of 272 cases（72.53%）were totally removed and 103 cases（27.47%）were sub-totally removed，confirmed by intra-operative observing and postoperative imaging.The patients were improved in 356 cases，poor in 19 cases and 5 cases died.Conclusion The individualized surgical treatment is based on the growth pattern and characteristics of craniopharyngioma.The total cut of the tumor with the protection of the pituitary-hypothalamic function remains the key to well prognosis and reducing relapse.

Key words: craniopharyngioma, surgical treatment, recurrence factors