Background: This study aims to review the clinical outcomes, extent of resection, complications, and prognostic factors in patients undergoing endonasal endoscopic resection (EEA) of anterior cranial base meningiomas. Methods: We conducted a retrospective review of 25 patients who underwent EEA resection of these lesions between 2001 and 2023. We assessed the extent of resection, complications, postoperative outcomes, and key technical aspects of the procedure. Results: 84% of patients were classified as ASA class III. Additionally, 64% of patients presented with visual disturbances. The mean blood loss was 472 ml. Intraoperative lumbar drains were used in 40% of cases, and dural sealants in 56%. A pedicled nasal flap was employed for reconstruction in 92% of cases. One vascular injury was documented, and 16% of patients developed a cerebrospinal fluid (CSF) leak in the postoperative period The degree of resection varied according to tumor location. Prognostic factors for achieving gross total resection, functional improvement, and key factors for reconstruction are discussed. The rate of CSF leaks decreased dramatically in the later years of the series Conclusions: Cranial base meningiomas can be successfully managed via a purely endoscopic endonasal approach, with acceptable morbidity and mortality rates.