To summarize the suitable approach for recurrent pituitary adenoma, fifteen patients with recurrent pituitary adenoma were re-operated via the transseptal sphenoid approach for the second time. During the operation, some degree of adhesion was noted in septal mucous membrane. The sphenoid cavity was filled with fibrous tissue which has correlated to the methods of reconstructing sellar floor during the previous operation. Follow-up study showed satisfactory results. It showed that transseptal sphenoid re-operation is still the best approach for treating recurrent pituitary adenoma in spite of some degree of operative difficulties.