Meningiomas involving the cavernous sinus have traditionally posed a major challenge for neurosurgeons and neuro-oncologists. Recent advancements in surgical techniques and radiotherapy have led to new treatment strategies for these difficult tumors. In this article, we review the current literature with respect to treatment options for cavernous sinus meningiomas. Additionally, we review the recent results of our experience at the University of Utah with decompression surgery followed by radiotherapy for cavernous sinus meningiomas.