Craniopharyngiomas (CPs) of the third ventricle are rare and can be difficult to treat due to their deep location and relation to neurological structures. A 60-year-old woman presented with a history of memory disturbances with progressive course. On examination, she was conscious but disoriented with time and place, visual field showed bilateral superolateral quadrantanopia, and KPS was 90. Brain images revealed a third ventricular mass that bowed the floor of the third ventricle, expanding into the supraoptic recess, compressing the optic chiasm downward and forward. The mass had solid and cystic components at its inferior and periphery. The patient underwent right pretemporal approach with orbital roof being removed, and a translamina terminalis route was used to reach the third ventricle and the tumor was completely removed. Preoperative localization of the ventricular CPs is essential to choose the optimal surgical approach to avoid undesired injuries and improve the surgical outcome.