Abstract: Surgery is the preferred treatment for most lateral skull base lesions. Due to the complexity of the anatomical structure of lateral skull base and its close adjacency to important blood vessels, cranial nerves and the brain, surgery prones to induce deadly or disabling complications, which limit the implementation of the surgery. Brain function, low cranial nerves, facial nerve and hearing are the priorities that should be taken care of during surgery. The key points for functional protection of organs include:a good balance between preservation of functions and resection of lesions, skillful surgical technique, and new instruments or equipment such as image navigation and interventional therapy.