Meningiomas are common intracranial primary tumors, most of which are benign, and are generally pushing and compressing to the surrounding brain tissue, with relatively good surgical results. Most meningiomas are located on the relative brain surface and the tumor also has a relatively intact envelope, so surgical excision is relatively simple, the surgical risks are relatively small, and the patient recovers relatively quickly after surgery. However, it would be a mistake to assume that meningioma surgery is a simple brain surgery. The risk of meningioma surgery is closely related to the location, size, texture, blood supply, and relationship with surrounding neurovascular and vital structures. Generally speaking, if the tumor is located at the base of the skull or in a deeper location and is blocked by brain tissue and bony structures, it is more difficult to reach the tumor location, which makes surgery more difficult and risky. If the tumor is too large, there are more important structures, nerves and blood vessels closely related to the tumor, and the risk and trauma of surgery are relatively large. If the tumor is hard, it is difficult to remove the tumor in pieces during surgery, which increases the difficulty of surgical operation. If the tumor is rich in blood supply, it will bleed more during surgery, which will affect the vision of surgical operation and also increase the risk of blood loss and shock during surgery. If the tumor is wrapped or adhered to important structures, nerves, blood vessels, etc., the possibility of damage to these structures increases when the tumor is removed surgically, and the risk of surgery increases. In the most complicated cases, meningiomas that have several of these high-risk factors are more difficult and risky to operate on, and these patients are also prone to neurological impairment and even coma death as a result of surgery. In neurosurgery, resection of meningioma of rock slope is a kind of surgery that is highly challenging for neurosurgeons, because this part of meningioma is located in deep skull base, surrounded by brainstem, many brain nerves and other tumor structures, and the tumor is often rich in blood supply, and it is closely attached to these structures and nerves and completely wraps these nerves, which is one of the hard bones of neurosurgery. Ms. Liao did not care about the headache symptom in these six months, and then gradually worsened and developed hearing loss on the right side, facial numbness, difficulty in swallowing, especially before the surgery, she could hardly swallow and eat normally, and the head MRI showed a huge meningioma in the rock oblique area. During the surgery, Dr. Ke Chao’s team from the Affiliated Cancer Hospital of Sun Yat-sen University found that the patient had these symptoms because the trigeminal nerve was completely wrapped by the tumor, and the facial nerve and the posterior group of cranial nerves were also partially wrapped, so they could only separate the tumor from the nerve adhesions and remove the tumor between the tiny gaps of the nerve. The surgery took five to six hours for tumor removal alone, and eight to nine hours in total. After the surgery, the nerves and important structures were preserved intact, and her swallowing function was restored. Ms. Huang, a young mother who had just given birth to a child 3 months earlier, had a similar rock-slope meningioma, and was having difficulty getting out of bed before the surgery. A brain MRI showed a meningioma on the left side of the rock slope with significant brainstem compression. Although the surgery was risky, she decided to stop breastfeeding and undergo the surgery. When her head was shaved before the surgery, her husband shaved his head together to encourage her. The procedure was also difficult, but she recovered well from the surgery and was able to get out of bed with little to no neurological damage. Fortunately, most meningioma surgeries are still routine neurosurgical procedures, and complex meningioma surgeries like this one are only part of the equation. Although these meningioma surgeries are difficult, the tumors are not too hard and they recover well after surgery. For some of the complex meningioma surgeries, it requires great physical strength, endurance and long-term training for the neurosurgeon to accomplish the intended goal, and it is not uncommon to have severe neurological impairment or even death in coma after such surgeries.