Objective　To report the clinical experience and outcome about ten middle-aged and old patients with visual deterioration rooting in nonfunctional pituitary adenoma.　Methods　The ophthalmologist diagnosed 10 cases pituitary adenoma patients who main complained of sudden or progressive damage on visual acuity and visual field. All the patients underwent surgical resection under nasal endoscopy; and the follow up lasted for at least half year.　Results　5 of the 10 patients who were respectively diagnosed within 1 month after onset of visual damage have excellent postoperative visual recovery. 5 other patients who had were misdiagnosed for longer than 6 months and severe visual damage had nothing visual improvement at postoperative one week, and four of five hadn't any visual improvement until 6 months postoperatively except one had improved to light perception.　Conclusions　Visual deterioration is often the only complaint of non-functional pituitary adenoma without any endocrine symptoms; this kind of tumor is inclined to be misdiagnosed. For the patients who are timely and accurately diagnosed, the clinical effect of endoscopic transsphenoidal surgical removal is reliable for its lower complication, which is valuable to extend in clinic.