The rich multidisciplinary environment in which skull base surgery has developed has allowed for significant progress in the field and has improved patient outcomes. More precise and detailed anatomic dissection in the laboratories has provided surgeons with the benefit of undertaking the serious technical challenges encountered in the skull base. Significant work has been done and continues to be developed in the field of adjuvant treatments including radiotherapy, chemotherapy, and hormonal therapy. Using biologic end points and specific genetic targets in the tumors may further expand our management options in the future.