The far lateral approach is a skull base surgical technique that provides access to the craniocervical junction, including the lower clivus, anterior foramen magnum, and upper cervical spine. Originally described by Roberto Heros in 1986 [1, 2], this approach has since evolved into a versatile method for treating various pathologies, such as vertebrobasilar aneurysms, foramen magnum meningiomas, and schwannomas of the lower cranial nerves [2, 3]. By extending the lateral suboccipital route and incorporating bony resection techniques, including transcondylar, supracondylar, and paracondylar modifications, the far lateral approach enhances surgical exposure while minimizing brainstem retraction [3, 4]. A thorough understanding of the surgical anatomy, including the vertebral artery’s extradural course, the cranial nerve pathways, and the bony landmarks of the occipital condyle, is essential to perform the approach, optimize patient outcomes, and reduce complications [3, 4].