Objective: Pituitary apoplexy is a clinical syndrome consisting of neurological and endocrine abnormalities secondary to hemorrhage or ischemia of an underlying pituitary adenoma. We assessed the role of emergency endoscopic transnasal hypophysectomy (done within 24 hours of presentation) in such a scenario. Materials and methods: Analysis of medical records of 3 patients was done who presented to the Department of Neurosurgery at PBM Hospital Bikaner with acute pituitary apoplexy, and a referral was sent to the Department of Otolaryngology for the feasibility of urgent endoscopic removal of the tumor. These patients subsequently underwent endoscopic endonasal transsphenoidal resection within 24 hours of the appearance of symptoms. All patients had undergone preoperative MRI demonstrating evidence of apoplexy in the form of intratumoral hemorrhage, ischemia, and necrosis. Any neurological deficits, partial or complete endocrinopathy were documented. Results: Preoperatively, neurological deficits including visual loss and cranial nerve palsies were found in all (100%) patients, endocrinopathy in the form of partial hypopituitarism was seen in 1 patient (33.33). All patients underwent surgery within 24 hours of symptom onset. All patients showed visual improvement. Complete restoration of normal vision in 66.66% of patients and resolution of preoperative oculomotor palsies in 66.66% of patients. Conclusion: Neurological deficits such as visual loss and cranial neuropathies show good improvement following surgical decompression, as does preoperative hypopituitarism. Early surgical intervention significantly affects the results.