Introduction: Endoscopic transorbital approaches have recently been described to manage complex orbital and skull base pathologies. Some selected tumors require a combination of these techniques with the endoscopic transnasal approach to allow a safer and more effective resection. The combination of these techniques results in a wider surgical field and an improvement in three-dimensional vision, with a lower probability of injury to neurovascular structures, a decrease in morbidity and presumably better resection rates. Experience in performing orbital lesions by transnasal route alone has led us to face more extensive cases, which forced us to seek combined techniques