Skull base surgery is a surgical field that involves the cooperation of multiple surgical and medical specialties, including neurosurgery, head-neck surgery, plastic-reconstructive surgery, radiation oncology, as well as multiple medical supporting teams. This field has been developed with the collaborative efforts of these medical specialties, and its history can be divided into five phases: Beginning of surgery(Prior to 1940); Early skull base surgery driven by the ENT-HN surgery group(1940-70); Conventional skull base surgery development based on anatomical, physiological knowledge and microsurgical equipment and technique(1970-90); Reflection and consolidation of the surgical dimension(1995-2005); and Evolution of endoscopic and new skull base surgical techniques(2005-). Several topics and advancements have improved this surgical field, such as access to the cavernous sinus, petrosal-temporal bone, and foramen magnum; concepts of minimally invasive surgical techniques; advanced endoscopic instruments; knowledge of biological assessments; and development of surgical robotics. To achieve a safe and effective surgery for cases of difficult cranial base lesions, clinicians must understand the origin of the surgical field, the detailed anatomy and physiology of the skull base, and the basic microsurgical techniques.