Multiple surgical approaches to the sella turcica have been described. The sublabial transseptal transsphenoidal approach provides a safe, cosmetically acceptable route to the sella with excellent exposure. Since 1976, we have employed this technique for the surgical treatment of pituitary neoplasms and parasellar tumors. The University of Washington experience with the sublabial transseptal transsphenoidal approach to the sella in a series of 253 patients is reported with respect to the otolaryngological aspects of the surgical technique, results, and complications of the procedure. In addition, a literature review of major studies that used this procedure is included, and the reported results and complications are compared to those of the present study.