AIM: Tuberculum sellae meningiomas (TSMs) are suprasellar lesions that commonly extend to the medial side of the optic nerve, resulting in visual impairments in the affected eye as the initial and most common symptoms. The primary goal of surgical treatment for TSM is the preservation or improvement of visual function. The aim of the present study was to assess the clinical outcomes of TSMs treated with microsurgery at our center. MATERIAL and METHODS: A retrospective analysis was performed on 56 patients with TSMs associated with visual impairments who visited our neurosurgery center between January 2008 and January 2012. These patients underwent microsurgery using the unilateral subfrontal approach (n=22), the lateral frontal base approach (n=28), or the frontotemporal approach (n=6). Outcomes were complete tumor removal, improvements of visual impairments and survival to the surgery. After surgery, patients were classified according to Simpson classification: Grade I in 22 cases, grade II in 28 cases, and grade IV in 6 cases. RESULTS: Postoperatively, visual impairments were improved in 47 cases, unchanged in 7 cases, and worsened in 2 cases. There was no patient's death. CONCLUSION: TSMs are operated in China with favorable outcomes.