This retrospective study compares paediatric with adult patients undergoing pituitary adenoma surgery over a period of 26 years at a single institution. All surgeries were performed via a sublabial approach using the operating microscope. An endoscope was used occasionally for resection of large tumours. In their cohort, the authors report higher frequency of secreting tumours and secreting macroadenomas in children compared to adults. Average follow-up after surgery was 58 months. The authors report similar remission rates between adults and children with Cushing’s disease, acromegaly and prolactinoma. Poor paranasal sinus pneumatisation in the paediatric population may be one the reasons for the authors preferring the sublabial approach instead of the transnasal endoscopic technique. The authors do not address the contentious issue of paediatric pituitary adenomas exhibiting a more aggressive and faster growth rate compared to adults as suggested by other studies. However, this paper adds to the literature on paediatric pituitary adenomas.