The suboccipital approach through a suboccipital craniotomy remains a cornerstone in neurosurgical access to the posterior fossa, cerebellum, and brainstem, requiring precise anatomical knowledge of the venous sinuses, foramen magnum, and surrounding bony landmarks [1]. The inion, asterion, mastoid processes, digastric points, and foramen magnum define the suboccipital craniotomy limits. The C1 (atlas) becomes relevant when posterior arch removal is needed for additional access to the lower brainstem and foramen magnum decompression [2, 3]. The transverse sinus and torcular Herophili at their confluence with the suboccipital sinus and sigmoid sinus serve as key reference points for planning safe dural incisions [1]. Midline suboccipital craniotomies can preserve structural integrity and reduce postoperative complications [4]. This approach, when executed meticulously, allows for maximal visualization while minimizing complications associated with posterior fossa surgery.