Objective To demonstrate various operative approaches to the removal of the tumors involving the anterior skull base and explore the effectiveness of the pericraniai flap in reconstructing the anterior skull base. Methods The clinical data of 47 patients with anterior skull-based tumors were retrospectively reviewed and analyzed: subffontal approach, extended subfrontal approach and combined craniofacial approaches were performed in 7, 8 and 32 patients, respectively; pericranial flap and galeo-pericranial flap were employed in the reconstructing the anterior skull base. Results Tumors were radically resected in 33, subtotally resected in 12 and partly resected in 2 patients with 21.2% overall complication rate. Conclusion The 3 approaches are highly effective in the removal of anterior skull-based tumors. The pericranial flap or galeo-pericranial flap was reliably and effectively used in the reconstructing anterior skull base with minimally complication rate and excellent endurance of postoperative radiotherapy.