The lateral type of pterygoid crest meningioma has late onset of symptoms. The tumor occurs on the large wing of the pterygoid bone and causes bone growth in the posterior lateral wall of the orbit and temporal area, resulting in orbital shrinkage, or the tumor invades directly into the orbit and causes proptosis of the eye. There are many causes of orbital shrinkage, including diabetes, hypertension, cerebrovascular disease, facial neuritis, neuronal disease, and muscle atrophy. Most of the tumors are endothelial type and fibrous type. There are two types of tumor growth, one is expansive growth, nodular with a narrow tip, larger and relatively easy to operate; the other is creeping growth, carpet-like, and widely adhered to the dura at the base of the skull, which is not easy to be completely cut by surgery, and forms different clinical manifestations according to its growth characteristics. The clinical manifestations of pterygoid crest meningioma depend on the site of the tumor. The early symptoms of medial type are obvious, and patients may show brain nerve compression manifestations, such as vision loss, at early stage. If the tumor invades into the orbit or supraorbital fissure, the ophthalmic venous return is obstructed and the patient may have symptoms such as protrusion of the eyeball. Patients with medial type may also have symptoms of II, IV, VI and V branch 1 brain nerve damage. Psychiatric symptoms and olfactory disturbance are mostly seen in patients with tumor growth in the anterior cranial fossa, but are less common. The lateral type of pterygoid crest meningioma has late onset of symptoms, with only headache and lack of localization signs in the early stage. Some patients may present with temporal lobe seizures and zygomatic-temporal bone bulge if the tumor invades the temporal bone. Both types of patients with large tumor growth can cause contralateral limb hypotonia and increased intracranial pressure.