An infratemporal fossa approach for extensive tumors of the temporal bone, clivus, and parasellar and parasphenoid regions features permanent anterior transposition of the facial nerve, resection of the mandibular condyle, and mobilization of the zygoma and lateral orbital rim. Obliteration of the pneumatic spaces of the temporal bone with permanent occlusion of the Eustachian tube and blindsack closure of the external auditory canal avoids the danger of postoperative infection and leads to primary wound healing in the shortest time. Three cases demonstrate selective utilization of the infratemporal fossa approach. Short-term results and complications were observed in 51 patients.