Introduction: Skull base chordomas are relatively rare malignant tumors with locally aggressive behavior. Surgical removal is the gold-standard of treatment and the extent of resection is the best prognostic factor. The challenging location of posterior clinoids behind the pituitary gland results in them not being resected very often and hence, potentially leaving residual in chordomas with upper clival extension. Favorable endocrinological outcomes and technical nuances of the interdural pituitary transposition have been described, but its routine use has not spread. The purpose of this study was to understand the role of endonasal transcavernous posterior clinoidectomy approach with pituitary transposition for the treatment of clival chordomas.