Objective To explore the surgical experience and application value of 3D exooscope-assisted transoral approach in the resection of parapharyngeal space tumors. Methods Clinical data of 9 patients who underwent 3D exoscope-assisted transoral approach for parapharyngeal space tumor resection at the Affiliated Drum Tower Hospital of Nanjing University Medical School from May 2024 to December 2024 were retrospectively analyzed. The key points of the surgical operation and clinical efficacy were summarized. Results The operation was successfully performed with complete tumor resection in all the 9 patients. The intraoperative blood loss was (9.4±3.9) mL, and the operation time was (46.1±6.0) min. After operation, all patients were given antibiotics to prevent infection and nasogastric feeding support. After the removal of the parapharyngeal space drainage tube, they gradually transitioned to oral feeding. Postoperative follow-up for 6 to 15 months showed no tumor recurrence. Conclusions 3D exoscope-assisted transoral approach for the resection of parapharyngeal space tumors is safe and feasible. It provides a clear stereoscopic field of view, is convenient to operate, and is conducive to precise dissection and hemostasis. This technique has the advantages of minimally invasive and rapid recovery, and has broad development prospects in the future minimally invasive treatment of oropharyngeal diseases.