Introduction: Approximately 250 million surgical procedures are performed annually around the world, and data suggest that major complications occur in 3 to 17%. Many of these complications can be classified as avoidable, and previous studies have demonstrated that preoperative checklists and improved OR teamwork decrease complication rates. Although our institution has instituted a general preoperative “time-out” designed to streamline communication, flatten vertical authority gradients, and decrease procedural errors, there is no specific checklist for endonasal transsphenoidal anterior skull base surgery, with or without endoscopy. Such minimally invasive cranial surgery includes a completely different conceptual approach, setup, instrumentation, and operative procedures, and subsequently can be associated with different types of complications as compared with open cranial surgery. We hypothesize that a detailed, procedure-specific preoperative checklist would be useful to reduce errors, improve outcomes, decrease delays, and to maximize both team building and operational efficiency.