Abstract: Objective To explore the clinical application and auxiliary significance of doppler ultrasonography assisted pituitary neoplasms transsphenoidal resection. Methods Twelve patients' clinical data was analyzed retrospectively who with pituitary adenoma treated by transsphenoidal approach assisted by color doppler ultrasound from March 2014 to March 2017, including 8 males and 4 females, aged 35-65 years, with an average age of 49.2 years. The characteristics of the tumors were as follows, the length ranged from 0.8 cm to 4.6 cm, 2 cases of pituitary microadenomas, 10 cases of pituitary macroadenomas, 2 cases of hormone secreting pituitary adenomas (including 1 case of growth hormone adenoma, 1 case of adrenocorticotropic hormone shorted for ACTH adenoma), and 10 cases of non-functional pituitary adenomas. The advantages and disadvantages of transsphenoidal ultrasound in all of the patients' operation were summarized and analyzed. Results The average operation time of twelve cases was 92 minutes. One case which considered as ACTH pituitary microadenomas according to endocrinological findings, there was no pituitary space-occupying lesions found on preoperative cranial MRI, and also no lesions found by intraoperative ultrasound microprobe. The remaining eleven pituitary adenoma lesions were detected by intraoperative ultrasonography, of which two cases were excised according to the guidance of ultrasonography. However, two other cases which involved the internal carotid artery were still impossible to remove the residual tumor tissue further, although the residual tissue had been found by intraoperative ultrasonography. After a 3 months follow-up, 9 patients (9/12, 75%) have attained the clinical cure or remission according to the biological and screening standard. Conclusions There is a good clinical application value of doppler ultrasonography assisted pituitary neoplasms transsphenoidal resection, because of its very clear imaging, more accurate anatomical location for important nerves and blood vessels during operation. Therefore, pituitary neoplasms can be removed without key anatomic site injury under the help of transsphenoidal ultrasonography.