Few data are available concerning the outcome of surgical removal of intracranial meningioma in elderly patients. Surgical criteria and prognostic factors are considerations in the decision as to whether neurosurgical removal should be attempted in elderly patients. The present study appears to be the first to examine the cognitive functioning of patients (n = 33) with intracranial meningiomas in the seventh and eighth decades of life prior to and following surgery. The time period between pre- and postoperative assessment was between 12 and 23 weeks. Twenty healthy subjects were also examined. For neuropsychological assessment, standardized test procedures including the examination of memory, attention, visuo-constructive abilities and executive functions were used. No significant deterioration of cognitive functioning was found following surgery. Elderly patients should not therefore be denied meningioma surgery purely on the basis of the risk of postoperative deterioration of mental functioning.