Abstract: Pituitary adenomas, the most common intracranial tumors, are usually benign. However, they may invade the adjacent structures, named invasive pituitary adenomas. Such tumors are characterized by refractory to traditional treatment and higher rate of early recurrence. Up to now, it is still a challenge for clinicians to manage the patients with invasive pituitary adenomas. Standard treatments are repeat surgery or radiotherapy, which can control hypersecretion, but have poor efficacy on tumor progression. Temozolomide is recommended as first-line chemotherapy drug for aggressive pituitary tumors, but it is only effective for partial patients. Peptide receptor radionuclide therapy, novel molecular targeted agents (mTOR inhibitors and EGF inhibitors) and immune­checkpoint inhibitors (ICIs) have been used in clinical researches, bringing hopes to the patients with invasive pituitary adenomas.