Pituitary microadenomas are small tumors whose maximal diameter is less than 1 cm. The aim of surgical removal of microadenomas should be not only the reversal of hormone hypersecretion but also the preservation of normal anterior pituitary function. Our series includes 230 patients with a microadenoma who had their first operation in our department: 45 were GH-secreting, 92 were PRL-secreting, 90 were ACTH-secreting, and 3 were TSH-secreting. Remission of disease was achieved in 81%, 77%, 91%, and 100% of GH-, PRL-, ACTH-, and TSH-secreting adenomas, respectively. There was no perioperative mortality and only 5 patients experienced a major complication. A total of 7 patients had diabetes insipidus for at least 6 months after operation. Hypopituitarism, not present in any patients before operation, developed in 3.5% of the cases. Our experience confirms that patients with microadenomas have the best chances of a successful operation. Since tumor size should gradually increase with time, we underscore the need of early diagnosis and treatment in patients with pituitary adenomas.