Large and giant type of auditory neuroma can lead to serious consequences due to huge tumor and compression of important nerve structures. For example, compression of facial auditory nerve leads to hearing loss and facial palsy; compression of trigeminal nerve leads to facial numbness and weakness of biting muscles; compression of posterior cranial nerve leads to hoarseness, choking and coughing; compression of cerebellum leads to imbalance of gait, unstable walking and leaning to one side; compression of brainstem leads to hemiplegia and change of vital signs, which is life-threatening; compression of middle cerebral aqueduct leads to obstructive hydrocephalus, headache, vomiting and other symptoms of intracranial pressure. The symptoms of increased intracranial pressure include headache and vomiting, advanced disease, and eventual death. Therefore, large, giant auditory neuromas are a great challenge for neurosurgeons. Professor Majid Sami, former president and current honorary president of the World Federation of Neurosurgery and director of the Institute of Neuroscience in Hannover, Germany, has been engaged in research and surgical treatment of auditory neuroma for a long time, and now has nearly 4000 cases of auditory neuroma surgery listed, and is the first person in the world to treat auditory neuroma in neurosurgery. I studied with Prof. Sami for one year, studied and summarized his research insights, and then used this technique to remove the huge type of auditory neuroma after I returned to China, and achieved more satisfactory results. I personally summarize Prof. Sami’s surgical resection technique for auditory neuroma as — microsurgical resection technique for auditory neuroma by convergence method at both ends. This technique is characterized by using the tumor-facial auditory nerve arachnoid interface to first grind open the internal auditory canal, remove the tumor within the internal auditory canal, and expose the internal auditory facial nerve. The tumor is then resected internally to reduce its size. Then the tumor brainstem interface was separated to find the facial nerve out of the brainstem. The tumor was resected from both ends of the tumor-brain interface between the internal auditory tract and the brainstem, and the tumor-facial nerve interface was separated while using the arachnoid interface. Finally, total excision of the tumor is performed to preserve the tumor-facial nerve. The tumor was firstly resected from the inside of a large, giant auditory neuroma for intratumoral decompression, and then the space created by the decompression was fully utilized to separate the tumor-facial nerve interface without pulling the cerebellum and brainstem, while neurophysiological monitoring including brainstem evoked potentials, somatosensory evoked potentials and facial nerve stimulation were used to assist in monitoring the brainstem function, which could preserve the facial nerve and reduce the pull on the brainstem to the maximum extent. Case presentation: The patient, male, 39 years old, had progressive hearing loss for 2 years with unstable walking and facial numbness for 6 months. Diagnosis at admission, left auditory neuroma, preoperative MRI scan (below): 10-day postoperative picture (below) 1-year postoperative picture (below) 3-year postoperative repeat MRI (below)