Abstract: Objecitve To determine the value of urine volume and urine electrolytes in postoperative management of patients with sellar tumors. Methods Medical records of 103 patients with sellar tumors in the West China Hospital from January 2009 to December 2009 were retrospectively reviewed. The patients were managed either based on blood electrolytes (Group A, n=56) or based on urine volume and urine electrolytes (Group B, n=47). The incidence of balance disturbance of water and electrolytes was compared between the two groups. Results The levels of blood electrolytes were normal in both groups 3 days after operations despite significant loss of electrolytes through urine. Balance disturbance of water and electrolytes was revealed 4-7 days after operations. Group B had a lower incidence of balance disturbance of water and electrolytes (17.02%, 8/47) compared with Group A (73.21%, 41/56, P<0.05). No gender difference in the incidence of balance disturbance of water and electrolytes was found. Higher incidence of balance disturbance of water and electrolytes was found in craniopharyngioma (P<0.05, vs. pituitary adenoma) and in the patients undergoing craniotomy (P<0.05, vs. transsphenoidal approach) in Group A, but not in Group B. Conclusion Better management of balance disturbance of water and electrolytes can be achieved for patients with sellar tumors through monitoring urine than through blood. It can also simplify the postoperative management of patients with sellar tumors.