Juvenile nasopharyngeal angiofibroma(JNA) is an uncommon, histologically benign vascular tumor that occurs exclusively in adolescent males. Of all angiofibromas, 10% to 20% may have intracranial extensions. Recently combined intracranial and extracranial excision on angiofibroma has resulted in a low morbidity and mortality and a greater chance for complete excision of the tumor. The authors had experienced 3 cases of juvenile nasopharyngeal angiofibroma with intracranial involvement. They were successfully managed via combined transmaxillary, transpalatal, midfacial degloving and frontotemporal craniotomy approach.