Transsphenoidal Hypophysectomy first evolved by Cushing in the early part of this century has become the mainstay of recent pituitary surgery since 1960. And this procedure has generally been via the sublabial transseptal approach. Despite the usefulness of the sublabial approach, there are certain drawbacks, such as limitation of exposure from the overhanging upper lip, loss of nasal tip projection, postoperative difficulties with dentures and numbness of the upper teeth. Columellar flap for transseptal transsphenoidal approach, is a modification to overcome those difficulties. This procedure is a simple and rapid technique for excellent surgical exposure of the sella turcica without significant cosmetic deformity. Authors experienced 4 cases of columellar flap for transseptal transsphenoidal approach.