The anterior cranial fossa (ACF) is a complex anatomical region at the forefront of the skull base, encompassing the basal cortex of the frontal lobe and the olfactory bulbs. Bounded anteriorly by the orbital rim and posteriorly by the sphenoid ridge, the ACF interfaces with the sphenoid sinus, nasal cavity, and orbit. Pathologies in this area can originate from intracranial or extracranial sources, including tumors and infections. Common ACF tumors include meningiomas, accounting for 12–20% of cases, while hemangiopericytomas (now known as solitary fibrous tumors) are rare. Esthesioneuroblastomas represent about 3% of intracranial tumors, typically arising from the olfactory epithelium. Surgical interventions for ACF lesions range from transcranial approaches, such as pterional and frontal methods, to endoscopic endonasal approaches (EEAs). Among these, the minimally invasive supraorbital approach has gained popularity for accessing the anterior and medial cranial fossae.