The term "empty sella syndrome" (ESS) indicates the presence of an enlarged Sella turcica which contains a remodeled pituitary gland by pressing it against the back and lower wall of the sellar space. The condition is the result of the expansion of the subarachnoid space in the sella as a result of the incomplete continuity of the sellar diaphragm. There are two types of empty sella syndrome (ESS) with a difference in repercussions on the endocrine system. Therefore, with regard to etiology, empty Sella syndrome may be primary, if there is no pathological process in the selar region itself which is the cause of damage to the pituitary gland, or secondary, if it was caused by a specific pathological process. Primary empty sella syndrome (PESS) may be an incidental finding or can be registered with imaging methods of examination of patients presented with endocrine disorders, neurological symptoms, visual disturbances, etc. It may be caused by intracranial hypertension and/or selar diaphragm insufficiency in patients who have not previously documented any pathology of the pituitary gland. Secondary empty sella syndrome (SESS) is much more frequent and associated with various pathological conditions and processes of the selar region. The presence of intrasellar masses changes the normal anatomy of the diaphragm, stretching, enlarging and thining it, and increases the chances of developing arachnoid adhesions that can withdraw the SVS to the sellar cavity. Radiotherapy, surgery, medication therapy, infections, post-partum pituitary necrosis, trauma and spontaneous resolution may induce a reduction in the sellar mass and stimulate the emergence of secondary empty sella syndrome associated with the development of scar tissue tissues, which after a few months of retraction can pull the supraselar structures causing visual deficits. The disease is treated appropriately to the disorder-medical therapy of endocrine disorders, surgical excision of intrasellar masses and adhesions and reduction of intracranial pressure.