目的　报告２３ 例枕大孔前及前外侧肿瘤的显微外科治疗。方法　分析２３ 例患者影像学特征、手术方法、手术结果、术后并发症等。结果　肿瘤全切１３ 例，次全切除６ 例，部分切除４ 例。手术死亡 ２ 例，术后颅神经损害加重 ２ 例，４ 例术后颅神经症状同术前，其余病例临床症状均有不同程度改善。结论　远外侧枕下入路适合切除枕大孔前及前外侧病变。 Objective To report the microsurgical treatment of 23 cases of occipital foramina and anterolateral tumors. Methods The imaging features, surgical methods, surgical results, and postoperative complications of 23 patients were analyzed. Results Thirteen tumors were completely resected, subtotal resection was performed in 6 cases, and partial resection was performed in 4 cases. Two patients died of operative death, and 2 cases had worsening of cranial nerve injury. Four patients had postoperative cranial nerve symptoms before operation. Other clinical symptoms were improved in different degrees. Conclusions The far lateral suboccipital approach is suitable for the removal of occipital foramen and anterolateral lesions.