The authors present three middle-aged patients (1 male, 2 females) presenting with empty sella on magnetic resonance or computed tomography imaging. Their main complaints were severe headache and dizziness. Neurological examination showed no abnormalities, except for local tenderness on palpation and percussion in the fronto-parietal or fronto-temporal regions. Endocrine evaluation showed no functional deficit of the pituitary gland. Visual fields, fundi and EEG records were normal as were the CSF composition and pressure, a skull X-ray radiograms showed an enlarged sella with thinned floor and blurred posterior oblique processes. MRI revealed a liquid space below the plane of the sellar diaphragm which pressed on the pituitary gland. The diagnostic and therapeutic problems of empty sella syndrome are briefly discussed.