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BACKGROUND With the evolution of surgical approaches, endoscopic skull base surgery has emerged as a suitable alternative to many other invasive methods. The current study investigates the efficacy and outcome of cranial endoscopy in treating various neurosurgical intracranial pathologies in terms of procedural success and complications. METHODOLOGY This observational, prospective, case series was conducted at neurosurgery department of DG Khan Medical College from November 2017 to October 2020. A total of 74 individuals having indications for cranial neuroendoscopy were enrolled. Clinical examination was performed, and a detailed history of the disease was obtained. The follow-ups of the study participants were conducted at the OPD of the DG Khan medical hospital. The collected data were statistically analyzed using SPSS version 20.0. RESULTS Of the 77 procedures, endoscopic third ventriculostomy (ETV), arachnoid cyst fenestration, septostomy, colloid cyst excision, endoscopic assisted ventricular catheter placement, and intraventricular tumour biopsy treatments were performed in 53.3%, 18.2%, 10.4%, 7.8%, 6.5% and 3.9% patients, respectively. Aqueductal stenosis was identified as the most common cause of obstructive hydrocephalous. Seizures and Cerebrospinal Fluid (CSF) leaks were the reported complications, i.e. 12% and 8.1%, respectively. The observed mortality rate was 2.7%. CONCLUSION Neuroendoscopic surgery has become safe and effective since the experience and learning lower the risk of complications and offer physiologic low-cost alternative intervention.