The article deals with the orbitozygomatic approach used in the treatment of pathological processes located in the anterior, medial and superior third of the posterior cranial fossa with special attention paid to suprasellar lesions. It presents a step-by-step guide to the surgical procedure, including potential complications. Furthermore, various modifications of the orbitozygomatic approach are discussed and several references from other authors are quoted with respect to the comparison of different approaches based on quantification criteria. The orbitozygomatic approach is the method of choice in the treatment of suprasellar lesions, in particular in the case of voluminous expansion. It allows for more radical resection, because the operational field is more extensive and operation in deep intracranial structures is easier.