Background: Far and extreme lateral approaches have become a mainstay treatment for lesions located at the anterolateral aspect of foramen magnum and its vicinity. However, there is a significant discrepancy between authors on what these approaches truly are, which leads to producing papers naming different techniques the same and same techniques differently. Methods: We performed literature search employing PubMed-MEDLINE and Scopus databases. The search terms referred to the nomenclature of far lateral approach (FLA), extreme lateral approach (ELA), and their variants. Finally, important papers on the topic from article references were also included, if deemed contributory. Results: In total, 37 articles were collected. Surprisingly, we found that not a single paper has addressed the confusing nomenclature directly yet. Nine truly separate variants of FLA and ELA were found. We implemented them intraoperatively depending on both patient and lesion characteristics. The essence about each is summarized. Conclusions: In the CNSF meeting, we will shortly discuss causes behind confusion and debate each FLA and ELA variants according to a number of authors and their unique yet sometimes confusing understanding of the approaches. Ultimately, a logical proposal for the unification is provided to stir up discussion