Background This paper aimed to elucidate the changes of hypothalamus-pituitary hormones in patients after total removal of craniopharyngiomas. Methods A total of 40 patients with craniopharyngioma s received surgery. The levels of triiodothyronine (T3), thyroxine (T4), thyrotropic hormone (TSH), antidiuretic hormone (ADH), and adrenocorticotropin (ACTH) were measureed in the 40 patients b efore surgery and one week after surgery respectively. Results Twenty-eight patients (70%) had hypothyroidism before surgery, but 38 (95%) had hypothyroidism after surgery (P<0.01). Twenty-three patients (57.5%) had diabetes insipidus (DI) before surgery and 38(95%) had DI after surgery (P<0.001). The pre- and post-operative levels of ADH were (2.49±0.30) pg/ml and (2.80±0.29) pg/ml respectively (P>0.05), whereas tho se of ACTH were (23.97±2.69) pg/ml and (15.60±1.91) pg/ml respectively (P<0.05). Conclusions Hormone deficits after total removal of craniopharyngioma appear to be the common complication of surgery. Hypothyroidism and diabetes insipidus are more frequen t after surgery than before surgery. Thyroxine and glucocorticoids should be administered routinely after total removal of craniopharyngioma. Background This paper aimed to elucidate the changes of hypothalamus-pituitary hormones in patients after total removal of craniopharyngiomas. Methods A total of 40 patients with craniopharyngioma received surgery. The levels of triiodothyronine (T3), thyroxine (T4), thyrotropic hormone (70%) had hypothyroidism before surgery, but 38 (95%) had Twenty-three patients (57.5%) had diabetes insipidus (DI) before surgery and 38 (95%) had DI after surgery (P <0.001). The pre- and post-operative levels of ADH were (2.49 ± 0.30) pg / ml and (2.80 ± 0.29) pg / ml respectively (P> 0.05), while tho se of ACTH were (23.97 ± 2.69) pg / ml and (P <0.05) Conclusions Hormone deficits after total removal of craniopharyngioma appear to be the complica tion of surgery. Hypothyroidism and diabetes insipidus are more frequent t after surgery than before surgery. Thyroxine and glucocorticoids should be administered routinely after total removal of craniopharyngioma.