Microsurgical approaches are the procedures of choice for high-risk patients with lesions requiring surgical treatment. The use of a microscope reduces the extent of the surgical invasion, thus minimizing the handling of healthy tissues. The authors present a surgical approach described for the first time in 1981, which has been used for the past 17 years in more than 260 patients with different tumors and vascular lesions of the anterior cranial fossa. The modification set forth in this article makes better exposure possible, allows more space for instrument handling, and improves cosmetic results. This particular report was based on the treatment of 41 patients who were observed for longer than 3 months. All of the patients were satisfied with the cosmetic result.