Aim:This study aims to evaluate the surgical outcomes in patients with Non-Functioning Pituitary Adenomas (NFHAs) exhibiting Visual Field Defects (VFD). Specifically, the study seeks to ascertain the impact of the volume of adenoma excised during surgery on recurrence rates and improvements in VFD.Material and Methods:From a cohort of 150 individuals diagnosed with NFHA and displaying suprasellar extensions accompanied by VFDs, 114 patients meeting the inclusion criteria were selected for further analysis after a comprehensive retrospective review. All selected patients underwent pituitary MRI scans, and volumetric measurements were conducted on the T1 contrast sequences using Synog.via software. Measurements were derived from MRIs taken 24 hours pre-operation, 24 hours post-operation, at the 3-month mark, and at the end of the first year post-surgery. Volumetric values obtained were then compared between patients who underwent subsequent surgeries due to recurrence and those who did not. Similarly, the variables were assessed for patients experiencing an improvement in VFD, those whose VFD remained stable, and those observing a deterioration in VFD.Results:The study found a recurrence rate of 19.3%. Among patients who underwent a second surgery due to recurrence, the pre-surgical adenoma volume, the adenoma volume removed based on the 24-hour post-operative MRI, and the volumes recorded in the 3-month and 1-year post-operative imaging were significantly greater compared to those who did not require a second surgery. Noteworthy improvements were identified in 84.2% of patients with VFD complaints and 62.5% of those with visual acuity (VA) complaints.Conclusion:The findings of this study indicate the significant impact of adenoma volume assessments on recovery from VFD and the need for a second surgery. Although the choice of surgical methodology does not definitively affect outcomes, valuable prognostic insights can be gained from an in-depth evaluation of variations in adenoma volume.