Approximately 30% of primary brain tumors are meningiomas; 90% of these are benign. The remaining 10% have aggressive pathological features and significantly higher recurrence rates. Treatments include surgery, radiation therapy, and other medical therapies. Management of these patients involves vigilant neuroradiological imaging, follow-up visits, symptom management, and ongoing patient and family teaching. Even with aggressive treatment modalities, morbidity and mortality rates remain high.