Aim:The pterional approach is a common procedure in neurosurgery but it has a broad degree of complications including temporal hollowing. The most of the patients who had temporal hollowing after pterional craniotomy have phychological, physical and social problems in rest of their lives. The purpose of this study is to investigate effect of osteoplastic pterional craniotomy on temporal hollowing and its sequelas.Material and Methods:97 patients who had pterional craniotomy for aneurysm surgery were analysed retrospectively. 63 of them were conventional pterional approach and 34 of them were osteoplastic pterional approach. Temporal muscle volume was calculated on postoperative 6th month CT bilaterally and differences between conventional pterional and osteoplastic approach were compared. Results:97 patients, 45 of whom were female and 52 of whom were male, were included in the study. The mean age of these patients was 50.37 years. Of the patients in the conventional group, 31 were female and 32 were male. Of the patients in the osteoplastic group, 14 were female and 20 were male. The left and right temporal muscle volume difference is not statistically meaningful in osteoplastic approach group while the temporal muscle volume is slightly decreased in conventional pterional approach group when compared the non-operated side. Conclusion:This study shows the osteoplastic pterional approach is superior to conventional pterional approach to keep muscle volume and function. Patients who underwent osteoplastic craniotomy demonstrated higher levels of satisfaction with their facial appearance compared to those who underwent craniotomy using the conventional pterional approach.