The paper summarizes the results of surgical treatment of patients with thalamic tumors of different topographic variants. Since 1985 till 2010 127 patients were operated, 147 direct surgical interventions were performed. Repeated surgeries were required due to partial resection of a tumor or recurrence. In most cases resection of tumors was performed via transcallosal (48%) and occipital interhemispheric (29%) approaches. Less common approaches included transcortical (frontal, temporal, parietal) (14%), pterional through lateral and basal parts of Sylvian fissure (6%) and subtentorial supracerebellar (3%). Selection of approach is based on topographic features of tumor within thalamus, direction of its growth and relations with adjacent structures (internal capsule, brainstem, hypothalamus, ventricular system). Each approach has its own advantages and drawbacks which are highlighted in the paper.