Introduction: The pterional approach (fronto–temporo–sphenoidal craniotomy) is the most common procedure used for the exposure of Sylvian fissure,frontal and temporal opercula. The tumors of the floor of middle cranial fossa and infra temporal fossa pose a difficulty in access through this approach. Modification of pterional approach, the transzygomatic access osteotomy is one of the core routes to approach infratemporal region. Transzygomatic osteotomy provides enhanced visualization of infratemporal fossa and floor of the middle cranial fossa. The infratemporal tumors may originate from tissues in the region or extending from surrounding tissues.

Method: A series of 5 tumors were treated by author in which 2 were primary in origin and 3 were extension of tumors from mandible. All the cases were approached through hemicoronaltranszygomatic osteotomy except in one case where rhytidectomy incision was given as the tumor was originating from mandibular angle extending to infratemporal region.

Result: The purpose of this article is to access the surgical outcome of the modified pterional approach for the infra temporal fossa tumors. The surgical exposure created by the modified pterional approach was excellent to individuate the tumor margins in all the cases. The depression created by the zygomatic arch osteotomy is aesthetically and functionally accepted by all the patients. Recurrence was noticed in 1case, following chemotherapy and radiotherapy the patient was deceased.

Conclusion:  The management of infra temporal lesions using the modified pterional approach gave an outcome which was both functional and aesthetically established and merely accepted by the patients.