Aim:Pineal region tumours include parenchymal tumours, germ cell tumours, and neuroecto-dermal tumours. Conventional open, endoscopic, and stereotaxic surgical procedures are the main approaches for providing clinical relief and obtaining a pathological diagnosis. However, the choice is difficult for tumours in deep and critical areas such as the pineal region. We investigated the treatment approaches and follow-up data of patients with pineal region tumours at our institution.Material and Methods:A retrospective study was planned to evaluate patients who diagnosed with a pineal mass between 2019 and 2022 whether incidentally or symptomatically. All patients were evaluated regarding their radiological findings, clinical, labrotary and radiological out-comes of surgery if any performed, intraoperative and postoperative pathological diag-noses, and radiological and symptomatic follow-up results for at least one year. Results:A total of 16 patients were grouped into 2; intervention and conservation groups, re-spectively. Nine out of 16 patients received intervention (surgery with or without ionis-ing radiation therapy) and remained 7 followed up without intervention. Seven patients in the intervention group were found to have triventricular hydrocephalus, and one had tetraventricular hydrocephalus. Endoscopic approach was the preferred surgical inter-vention in all operated patients which was conventional endoscopic third ventriculosto-my (ETV) via a right-sided frontal burr hole. Five patients required a simultaneous ex-ternal ventricular drain. Neuronavigation was used in all the procedures. Conclusion:Neuroendoscopic intervention is a relatively safe, effective, low-cost initial procedure with low morbidity rates and enables patients to return daily life rapidly. Neuroendos-copy is the best approach for simultaneously providing tissue sampling and diversion of cerebrospinal fluid via ETV or septostomy in hydrocephalic patients with tumours in the pineal region.