This study presents the Endoscopic One Nostril Transseptal Transsphenoidal Approach (EONOTTA) as a minimally invasive surgical technique for se-lected cases of pituitary macroadenomas. Derived from the classic endoscopic endonasal approach, EONOTTA allows excellent exposure of the sellar re-gion while preserving nasal mucosa and olfactory function. The technique offers comparable disease control to standard endoscopic endonasal ap-proaches, with reduced sinonasal morbidity and postoperative discomfort. Despite limitations such as retrospective design and small sample size, findings support EONOTTA as a safe, efficient alternative for non-extended pituitary tumors requiring limited surgical exposure.