A 48-year-old female presented with intermittent headache for 3 years and gradually deteriorating vision in both eyes. On examination, patient was conscious, alert, with no sensori-motor deficit. The visual acuity in right eye was 3/60, while in the left eye it was 6/36. She had left homonymous hemianopia. There was no restriction of extra-ocular movements. There was no endocrinological abnormality on evaluation. On noncontrast computed tomography (NCCT) head imaging, a hyperdense lesion was seen in the suprasellar region. On magnetic resonance imaging (MRI) examination, the lesion was hypointense on T1-weighted (T1W), hyperintense on T2-weighted (T2W), with homogenous contrast enhancement, centered over the PCP. On MR angiography, the tumor was displacing the right P1 and P2 segments posteriorly and the ICA was displaced anteriorly and laterally []. The patient underwent a single piece FTOZ craniotomy with wide splitting of the sylvian fissure. The tumor was initially approached through the carotico-optic corridor and was decompressed. The perforators arising from the ICA as well as the posterior communicating and the anterior choroidal artery were draped over the tumor. To avoid manipulation and injury to these perforating vessels, the surgical trajectory was then shifted lateral to the ICA, along the tentorial edge and posterior to the third nerve. A basal FTOZ craniotomy combined with wide sylvian fissure splitting allowed the temporal pole to fall posteriorly and laterally, so that an anterior subtemporal trajectory was available without any temporal lobe retraction. The tumor was therefore accessed from posterior to the perforating vessels. The tumor had a small attachment to the PCP on the right side. Intraoperatively the tumor was grayish, firm, moderately vascular and near total tumor removal with coagulation of its dural attachment was done. Postoperatively, the patient remained stable with partial right third nerve paresis (patient had right ptosis, but no restriction of extra-ocular movements) and was discharged on 10th postoperative day. The histopathological examination of the lesion revealed meningothelial meningioma. Patient on follow-up at 3 months had improvement in ptosis. Postoperative MRI demonstrated complete excision of the lesion.