Acoustic neuromas are benign schwannomas that arise from the vestibular portion of the eighth cranial nerve. Small tumors confined to the internal auditory canal may be removed via an extradural subtemporal approach. Tumors that involve the cerebellopontine angle require posterior fossa craniotomy utilizing either the suboccipital or translabyrinthine technique. The choice of surgical approach depends primarily on the size of the tumor, its location, and the status of hearing in the involved ear. Operative mortality is very low. The most common sources of morbidity are hearing loss and facial nerve dysfunction.