Hypoglossal neurinoma is vary rare cranial base neoplasm. With the recent advances in the neuroimaging and surgical technique, radical surgical resection is amenable. A case of hypoglossal neurinoma which is located ventral to the medulla is reported. The patient was presented with right hypoglossal nerve palsy, glossal hemiatrophy, and decreased gag reflex on the right side. Magnetic resonance imaging(MRI) revealed an ovoid mass ventral to the medulla with enlarged hypoglossal canal. Because of the ventral location of the mass, far lateral transcondylar approach was selected to minimize the postoperative morbidity. Radical total resection was achieved. This report describes that far lateral transcondylar approach is better than conventional suboccipital approach in regards to satisfactory exposure of the hypoglossal canal and prevention of excessive retraction of the neuraxis.