PURPOSE: To describe a combined transcranial-orbital approach for en bloc resection of optic nerve gliomas with preservation of the annulus of Zinn that minimizes recurrence and prevents postoperative paralytic ptosis.DESIGN: A retrospective, noncomparative, interventional case series.STUDY POPULATION: All patients who underwent optic nerve glioma resections using this technique with the authors between 1994 and 2010.PROCEDURE: A transcranial-orbital approach is used to resect the intracranial segment of the optic nerve glioma from 2 mm anterior to the chiasm to the posterior extent of annulus of Zinn.