Resection of cavernous malformations located in the third ventricle represents a great surgical challenge because of its eloquent surrounding anatomy and depth. 1,2 A total resection of the lesion is required to avoid a recurrent hemorrhage which is associated with increased morbidity and mortality. 3,4 In this operative video, we present an operation for a patient with a cavernous malformation located in the left perithalamic region toward the third ventricle with previous hemorrhagic events. The selected surgical approach was the transcortical transchoroidal approach. This approach is preferred over the anterior transcallosal approach, as it provides better access to the lesion without damage to corpus callosum. Furthermore, the transcortical transchoroidal approach allows a better exposure to lesions located in the contralateral hemisphere compared with the transcallosal approach, especially for a total resection. [5][6][7][8] Hence, the trajectory was created through the middle frontal gyrus on the right hemisphere. The patient signed the institutional consent form stating that she accepts the procedure and allows us to use her images and videos for any type of medical publications in conferences and scientific articles.