From January 1985 to April 1987, 60 patients with orbital space-occupying lesions were treated surgically. Orientation and spatial localization of the lesion had already been achieved preoperatively by means of imaging methods. The decision on whether to use a neurosurgical transcranial, or a facial surgical approach, was made on this basis. The less elaborate procedure in each case was given preference to obtain a representative tissue sample. The definitive planning of the operation was then carried out with knowledge of the histology: a transcranial operation alone or as an additional measure was only necessary in six patients. Either definitive tumour therapy could be performed with or without temporal osteotomy in the remaining 54 patients exclusively via an anterior orbitotomy, or further oncological treatment was commenced after histological verification of the diagnosis.