To investigate the feasibility of endoscopic transnasal reconstruction of skull base defect with titanium mesh. Eight cases were selected to reconstruct their anterior skull base defects by endoscopic transnasal approach with titanium mesh between April, 2006 and January, 2007. Pathologies of these cases included two esthesioneuroblastomas, one squamous cell carcinoma, one chondrosarcoma, one malignant fibroma, two meningiomas, and one chordoma. The defects involved anterior-medial skull base in 2 cases, anterior skull base-sellar turcica in 2 cases, and anterior skull base sellar turcica-clivus in 4 cases. All patients were followed up for 2 to 10 months after operation and were monitored with endoscopic examinations and imaging. Replacement of titanium mesh was found in one case and other seven cases were successfully reconstructed without replacement of titanium mesh. Endoscopic transnasal reconstruction with titanium mesh is a feasible technique for defects of the anterior skull base. This procedure is simple and safe. Result of this protocol is desirable.