The extremely complex anatomic relationships among bone, tumor, blood vessels and cranial nerves remains a big challenge for cranial base tumor surgery. Therefore, a good understanding of the patient specific anatomy and a preoperative planning are helpful and crucial for the neurosurgeons. Three dimensional (3-D) visualization of various imaging techniques have been widely explored to enhance the comprehension of volumetric data for surgical planning.1 We used the Destroscope Virtual Reality (VR) System (Singapore, Volume Interaction Pte Ltd, software: RadioDexterTM 1.0) to optimize preoperative plan in the complex cranial base tumors. This system uses patient-specific, coregistered, fused radiology data sets that may be viewed stereoscopically and can be manipulated in a virtual reality environment. This article describes our experience with the Destroscope VR system in preoperative surgical planning and simulation for 5 patients with complex cranial base tumors and evaluates the clinical usefulness of this system.