Object: Smaller exposures, endoscopic approaches, and minimally invasive neurosurgery have emerged as a dominant trend in the modem era.In keeping with this evolution, we have recently eliminated the use of fixed retractors, instead employing dynamic retraction with the use of handheld instruments.Here, we report our results utilizing this strategy for challenging vascular and skull base lesions.[Methods] This 6-month study prospectively analyzed the use of retractorless surgery in a consecutive series of 223 patients with intracranial vascular or skull base lesions undergoing craniotomy by the senior author (RFS).[Results] The most common microsurgical approach used was an orbitozygomatic craniotomy (n=77, 35%)followed by frontal (n=36, 16%), retrosigmoid (n=27,12%), interhemispheric (n=16, 7%), and lateral supracerebellar (n=15, 7%) approaches.The most common lesions were aneurysms (n=65, 52%), 18 of which required bypass.There were also 46 (29%)cavernous malformations.Meningiomas were the most common skull base tumors (n=37, 58%).Of the 223 patients, seven cases of a variety of vascular and skull base lesions required fixed retraction.Therefore, 97% of the cases were successfully treated without the need for a self-retaining retractor system.[Conclusions] Fixed retraction can be supplanted by dynamic retraction with surgical instruments, limiting the risk of retractor-induced tissue edema and injury.This quiet revolution has precipitated a major change in our surgical techniques.Extensive dissection of arachnoidal planes, careful placement of the handheld suction device, patient positioning that enhances gravity retraction, the refinement of microsurgical instrumentation, and appropriate selection of the operative corridor all serve to obviate the need for fixed retraction in most intracranial procedures.Retractorless neurosurgery is an achievable goal, even when complex lesions of the vasculature and skull base are being treated.