The results of surgical treatment in 21 patients with meningiomas of the craniovertebral junction are presented. Main clinical diagnostic criteria in relation to the site of a tumor relative to the brain stem are considered. The basic surgical approaches used in the surgical treatment of meningiomas of the craniovertebral junction are described. These include posterior, median, posterolateral, transcondylar approaches. Surgical techniques to remove meningiomas having a matrix of varying areas were concretized, this is also done in relation to the consistency of a tumor. The outcomes of surgical treatment are analyzed. Possible postoperative complications and measures of their prevention and treatment are considered.