Introduction: Pituitary adenomas are the most common tumours of the sella turcica region, representing 10–15% of all primary intracranial tumors. They can be divided into macroadenomas and microadenomas, and also into non-active adenomas and hormonally active tumors. Although they are usually limited to the sellar region, larger ones can cause its destruction, infiltrate or compress adjacent structures, such as the optic chiasm, and therefore lead to a more aggressive clinical course. The case report is presented of a 66-year-old female patient with a giant pituitary tumour accompanied by obstructive hydrocephalus, in which the tumour was big enough to cause severe neurological symptoms and required urgent surgical intervention. Objective: The aim of the study was to describe the correct management in the case of giant pituitary tumours which could lead to rapid deterioration of the general and neurological condition of the patient.