Objective：To summarize the surgery strategies for the third ventricle craniopharyngioma. Methods：Clinical data of 28 pa－tients treated in our hospital were retrospectively analyzed. The surgery effect and indications between lamina terminalis approach and the anterior interhemispheric fissure-corpus callosum-septum pellucidum-interforniceal approach were compared. Results：There was no significant statistical differences in the gross tumor resection rate between these two kinds of approaches（P=0.907）. The anterior interhemispheric fissure-corpus callosum-septum pellucidum-interforniceal approach had higher rate of post-operation complications as diabetes insipidus（P=0.027）and electrolyte disturbance（P=0.033）. The lamina terminalis approach is suitable for tumors resection with main part under the third ventricle and above optic chiasma，while the anterior interhemispheric fissure-corpus callosum-septum pellucidum-interforniceal approach is suitable for tumors resection with main part in the third ventricle. Conclusion：Selecting a ap－propriate operation approach and protecting the hypothalamus and the pituitary stalk according to the imaging characteristics of the tumor are the keys of the surgery.