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<p>Pituitary adenoma is a common primary tumor in central nervons system. The aggressive pituitary adenomas show invasive characteristics with higher recurrence rate and worse prognosis, which normally need the comprehensive therapy of surgery, radiotherapy and chemical medications. The therapy of aggressive pituitary adenomas by temozolomide and whether O⁶-methylguanine-DNA methyltransferase (MGMT) could predict the curative effect of temozolomide have become hot spots in recent years. This review intends to illustrate the advance of the therapy of aggressive pituitary adenomas by temozolomide.</p><p> </p><p><strong>DOI: </strong>10.3969/j.issn.1672-6731.2015.12.017</p>