Objective To investigate the clinical features and microsurgical outcomes of patients with parasellar cavernous hemangiomas.Methods The clinical data and prognosis of 12 patients with parasellar cavemous hemangiomas treated with microsurgery were retrospectively analyzed.Magnetic resonance imaging showed that cavernous hemangiomas appeared slight hypointensity on T1WI,hyperintense on T2WI,and significant contrast on enhancing.Results Total resection and sub-total resection was achieved in 9 and 3 patients.No death occurred postoperatively.After operation,all patients were released from intracranial hypertension.In 6 patients who had visual disorder,5 patients improved and 1 patient had no change.In 5 patients who had eyeball motor disorder,3 patients improved and 2 patients had no change.In 4 patients who had pituitary gland dyshormonism,2 patients improved and 2 patients had no change.At postoperative early stage,diabetes insipidus and serum electrolyte disorder occurred in 3 patients,2 patients developed oculomotor paralysis.Patients were followed up (30.51 + 2.57) months.Three patients recovered from diabetes insipidus and serum electrolyte disorder,and 1 patient recovered from oculomotor paralysis.No patient suffered tumor recurrence or regrowth.Conclusions The correct diagnosis of parasellar cavernous hemangiomas can be achieved according to the preoperative MRI.Microsurgery is the first-line therapy for parasellar cavernous hemangiomas.