Background: In-hospital Endocrinology consultation (IHEC) following transsphenoidal surgery is often routine but may be -unnecessary, lead to excessive blood testing, and prolong in-hospital stay. Purpose of this study: to determine whether the necessity of IHEC can be predicted by a standardized operative assessment tool. Methods: Retrospective review of all transsphenoidal surgeries from January 1, 2016, when we instituted an operative assessment tool to identify patients for which IHEC is required. Minimum follow-up: 3 months. Results: 78 patients (42 male; mean age: 57 yrs); the assessment tool identified 17 patients (22%) for IHEC and accurately identified those who would not require IHEC. IHEC patients had longer hospital stay (8.3 vs. 2.9 days), higher rate of new post-operative hormonal deficit (17.6% vs. 0%) and higher 30-day readmission rates (35% vs. 16%). Less than 10% had transient symptoms attributable to steroids; there were no long-term complications from routine post-operative steroid administration. Conclusions: Use of our operative assessment tool shows that at least three quarters of pituitary surgery patients can be managed safely without IHEC. Our data indicate that identifying these patients may reduce in-hospital stay and costs with no evidence of compromise of hormone-related care.