Meningeal leukemia is a rare type of leukemia, which mostly occurs in leukemia-induced remission and complete remission. It can be misdiagnosed as various diseases of the skull and brain due to symptoms of cerebral nerve damage, spinal nerve damage, increased intracranial pressure, and symptoms of meningeal irritation depending on the location and extent of the lesion, and the preferred clinical drug is chemotherapy drugs. For meningeal leukemia, leukemia tumor cells enter the central system through various pathways, mostly invading the dura mater and arachnoid, and patients may have obvious symptoms of increased intracranial pressure such as dizziness, headache, nausea, vomiting, visual impairment, blurred consciousness and drowsiness. Chemotherapeutic drugs that can easily cross the blood-brain barrier are preferred for treatment, including methotrexate for injection, cytarabine hydrochloride for injection and prednisolone acetate injection, etc. These three drugs can also be combined for intrathecal injection in the lumbar spine until the cerebrospinal fluid returns to normal. Intrathecal injections can be administered within the chemotherapy period or independently, and need to be administered only in the absence of significant fever and myelosuppression. Meningeal leukemia suggests a severe disease, mostly high-risk, with a relatively high mortality rate and a tendency to relapse or to be accompanied by infiltration of other sites, such as the testes and bones. When symptoms such as increased intracranial pressure appear, one needs to be alert and promptly visit the hematology department of a regular hospital.