Abstract: Cavernous hemangioma is the most primary benign orbital tumor in adults, and majority of cases could be easily settled by surgical treatment. However, cavernous hemangioma lodged deep in the orbital apex remained a challenge because the surgery may pose a high risk of injury to the optic nerve and significant visual loss. This presentation would report a case of cavernous hemangioma located in orbital apex who presented superonasal and inferotemporal peripheral vision defect. The patient received fully transnasal endoscopic surgery, and a 2 cm × 1.5 cm tumor was successfully removed from the left orbital apex. The treatment results were satisfactory, with no after-effects and adverse reactions during follow-up. This case highlighted that transnasal endoscopic surgery is a promising technique for cavernous hemangiomas that are located deep in orbital apex. This approach provides direct pathway to tumor with limiting morbidity, maximal surgical field and ample illumination. The procedure represents a safe and less invasive management.