This is an excellent review article covering the pathology of pituitary adenomas (PA) as well as rare sellar lesions like lymphocytic hypophysitis that require aggressive treatment. The authors have preserved the 2017 World Health Organization (WHO) classification of PA and pituitary carcinomas in the review. However, they also discuss the proposed nomenclature changes for pituitary neuroendocrine neoplasms (PitNETs). Due to lack of studies to validate the terminology ‘atypical adenoma’, the International Agency for Research on Cancer has recommended that all pituitary tumours be classified as PitNET. Besides discussing the current knowledge of pituitary transcription factors, the authors also discuss how the diagnosis of pituitary carcinoma is retrospective after identification of cranio-spinal or distant metastasis and not at the time of initial diagnosis of PA. Their review is accompanied by stellar histopathology pictures and is a must-read for all skull base surgeons.