Objective:To review clinical presentation and surgical outcome of pituitary apoplexy and to explore the clinical significance of presurgical serum prolactin level.Methods:Clinical,diagnostic and therapeutic data were collected from pituitary patients admitted to our hospital from October,2010 to October,2012.Pituitary apoplexy patients were followed up for an average of 440 days.Special attention was paid to the relation between presurgical serum prolactin level and illness severity or outcomes.Results:545 pituitary tumor patients were admitted to our hospital during that period,including 38 pituitary apoplexy cases.9 out of 17 patients in low prolactin level group acquired severe visual impairment,comparing with only 2 out of 21 patients in normal or high prolactin level group(P<0.01).Similarly,9 out of 17 patients in low prolact in level group acquired severe trophic hormone deficiency,however,only 4 out of 21 patients in normal or high prolactin level group suffered from that(P<0.05).Long-term visual recovery was positively correlated with presurgical prolactin level with a correlation index of 0.568.Meanwhile,long-term hormone replacement was negatively correlated with presurgical prolactin level with a correlation index of-0.444.Conclusion:Our results suggested that presurgical serum prolactin level might be an early severity and prognostic marker of pituitary apoplexy.