An endoscopic anterior skull base resection may be necessary in select neoplasms. Obviating the need for any external incisions, this approach has become increasingly valuable to address a number of sinonasal neoplasms affecting the anterior skull base, through a minimally invasive technique. This video reviews the endoscopic anterior skull base approach for a typical esthesioneuroblastoma. It also touches on the reconstructive technique using a free alloderm graft, which has been in use by us for over 10 years, and has yielded consistent results, with no CSF leaks.