The development of new technologies such as neuroendoscopy has made neurosurgery more minimally invasive, but for classical diseases like convex meningiomas, no better way to deal with them can be thought of yet, except surgery. Non-cranial base meningiomas can be divided into two generational categories, one being root sinus-associated meningiomas. The other category is non-sinus-related meningiomas. The presence of perisinus arachnoid granules provides an anatomical basis for meningioma development. Sinus-related meningiomas are more difficult to resect. During this week, our department performed two surgeries for sagittal sinus meningiomas, both of which were very large, one was a paranasal meningioma and the other was a complete sagittal sinus meningioma. In both cases, the preoperative symptoms were mild and the tumors were already huge at the time of discovery. Regardless of whether it is an intracerebral or extracerebral tumor, as long as it is large in size, it is very difficult to remove. In particular, the sagittal sinus meningioma from Tangshan was very difficult to resect from the frontoparietal to the occipital region. First, the position of such patients needs to be semi-sitting, which requires careful adjustment of head position after head frame fixation, but the semi-sitting position should prevent air embolism after sagittal sinus opening. Secondly, bleeding should be closely controlled during craniotomy, because of the multiple sources of blood supply such as scalp blood supply, lamina cribrosa vein, and dural blood supply, so it is necessary to take a step-by-step approach during craniotomy, and choosing a bone flap with periosteum to open the craniotomy is very effective in controlling blood leakage from the lamina cribrosa vein. Furthermore, the dural vessels should be carefully hemostatic, and only by blocking the meningeal blood supply can we ensure less bleeding during tumor resection. The most critical issue is the protection of veins in the border area during tumor resection. In this type of tumor, the sagittal sinus is either narrowed or occluded, and the cortical sagittal sinus back is affected. The normal cortical return can only return to the normal sagittal sinus through the veins around the tumor, and if the marginal veins are destroyed, the function of the cortex will undoubtedly be affected. The cortical layer at the edge of the tumor often performs important functions and cannot be easily aspirated. In addition, during cranial closure, the scalp should be hemostatic again to eliminate the occurrence of epidural hematoma. If there is limb dysfunction after surgery, it is important to pay attention to whether the limb is hard or soft palsy; if it is hard palsy, the possibility of muscle strength recovery is very high. The first patient with postoperative muscle strength grade 0 + hard palsy woke up from a nap with muscle strength already recovered to grade 3. Tumors in the sagittal sinus may remain, so patients should be reviewed periodically and if there are signs of recurrence, supplemental radiation therapy may serve a better purpose. Meningioma of the sagittal sinus requires careful surgery and only traditional hands can wield the knife to cut it off.