In the book, the anatomy of the posterior fossa and the main approaches are described together, using many pictures of cadaver speciemens and color illusturations of step by step procedures of the surgical approaches. The author also presents a number of surgical cases in order to suggest appropriate approach to those cases. In this book, the surgical anatomy of the posterior fossa is first explained and then surgical approaches are presented based on the anatomical explanation; therefore, it will be easy for the readers to understand the procedures. This book was written in Japanese, published about 4 years ago, and has had very good reputations especially among young neurosurgeons who are going to study various surgical approaches and techniques. As it is translated into English, some parts are revised and new information is added. The author hopes that many neurosurgeons in the world will perform safer operations after gaining a new knowledge from this book.