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Objective To evaluate the emergence agitation and recovery quality of patients with 3 endocrine types of pituitary tumor after transnasal transsphenoidal hypophysectomy. Methods Patients who received pituitary adenoma resection under general anesthesia were enrolled and categorized into three groups: growth hormone group (GH), adrenocorticotropic hormone group (ACTH) and non-functional group (control). Riker Sedation-Agitation Scale (RSAS), the severity of the emergence coughing, headache (by VAS), medical staff satisfaction were recorded in the post-anesthesia care unit. QoR-40 score, headache(by VAS), nausea score (by VRS) and vomiting score, and patient satisfaction were recorded at 24 h postoperatively. Results 163 cases were enrolled in the analysis, including 51 in GH group, 44 in ACTH group and 68 in control group. No significant difference was found regarding the emergence agitation among 3 groups. The ACTH group showed significantly higher nausea VRS score at 24 h after surgery than control group (P＜0.01). The headache VAS score of ACTH group was significantly higher than that in control group (P＜0.001). The incidence of postoperative sore throat in ACTH group was significantly higher than that in control group (P＜0.05). The postoperative QoR-40 score of ACTH group was significantly lower than that of control group (P＜0.01). Conclusions The incidences of postoperative nausea, headache and sore throat are significantly increased and the score of QoR-40 is significantly reduced in patients with ACTH pituitary adenoma.