To seek for the best surgical approaches to the skull and near-skull base neoplasms.161 patients with skull or near-skull base tumors were surgically treated. The surgical approaches were craniofacial approach in 6 cases, total maxillectomy or/with orbital exenteration in 5 cases, lateral rhinotomy in 7 cases, frontorbital approach in 1 cases, maxillary swing or extended maxillary swing approach in 21 cases, mandibular swing approach in 30 cases, cervical approach in 48 cases, postaurical large C incision approach in 19 cases, transparotid approach in 8 cases, transoral approach in 6 cases, temporofrontal approach in 8 cases, subtemporal preauricular approach in 2 cases.Of the 98 benign tumors cases, 2 recurred postoperatively. Of the 63 malignant tumors, 1 case had cerebrospinal fluid leakage and died of intracranial infection 1.5 months postoperatively. In the follow up period, the longest one survival was over 8 years, and 10 over 5 years, 19 over 3 years, 16 over 2 years, 16 over 1 year. Survival rates of 3 and 5 years were 59.18% and 38.46% respectively.According to the site, range and pathology of the skull base neoplasmas, surgical approaches were designed and selected rationally and the effects better.