Endoscopic transorbital approach to recurrent clinoidal meningioma

Anterior clinoid meningiomas are challenging lesions due to their proximity to critical neurovascular structures. Traditional surgical approaches often require extensive bone removal and brain retraction, increasing the risk of complications. The transorbital endoscopic approach has emerged as a novel, minimally invasive alternative, offering direct access to the anterior cranial base and parasellar region through the orbital cavity, minimizing manipulation of brain tissue while maintaining effective tumor resection. Current evidence supports its feasibility and safety in selected skull base cases. The authors present the case of a 66-year-old woman with a recurrent atypical anterior clinoidal meningioma previously treated with a frontotemporal craniotomy. The video can be found here: https://stream.cadmore.media/r10.3171/2025.10.FOCVID25171.