Objective To investigate the effect of endoscopy versus microsurgery on the serum levels of matrix metalloproteinase-9 （MMP-9）， insulin-like growth factor-1 （IGF-1）， and hormone-related indices after surgery in patients with pituitary adenoma.Methods A total of 96 patients with pituitary adenoma who were admitted to Department of Neurosurgery， Handan Central Hospital， from January 2017 to January 2020 were divided into endoscopy group （neuroendoscopic tumor resection） and microsurgery group （microscopic tumor resection） using a random number table. Surgical indices and postoperative complications were recorded for the two groups， and the serum levels of MMP-9， IGF-1， prolactin （PRL）， growth hormone （GH）， and adrenocorticotropic hormone （ACTH） were measured before surgery and on day 3 after surgery.Results Compared with the microsurgery group， the endoscopy group had a significantly longer time of operation and a significantly better degree of tumor resection （P <0.05）. Compared with the microsurgery group after surgery， the endoscopy group had significantly lower serum levels of MMP-9 （72.39±10.53 μg/L vs 80.18±13.42 μg/L， P <0.05）， IGF-1 （298.64±42.75 ng/mL vs 319.61±41.96 ng/mL， P <0.05）， PRL （1.36±0.44 nmol/L vs 1.67±0.53 nmol/L， P <0.05）， GH （0.96±0.28 nmol/L vs 1.39±0.37 nmol/L， P <0.05）， and ACTH （4.28±0.72 nmol/L vs 4.85±0.74 nmol/L， P <0.05）. There was no significant difference in the overall incidence rate of postoperative complications between the endoscopy group and the microsurgery group （10.42% vs 27.08%， P >0.05）.Conclusions Compared with microsurgery， neuroendoscopic surgery has a longer time of operation and advances in reducing the serum levels of MMP-9， IGF-1， and hormone-related indices after surgery.