Malignant meningioma is a tumor with certain features of benign meningioma that gradually undergoes malignant changes and presents as a malignant tumor. It is characterized by multiple recurrence of the tumor at the original site and can undergo extracranial metastasis. Malignant meningioma grows fast and the tumor invades into the surrounding brain, causing gliosis in the surrounding brain tissue. With repeated surgical resection, the tumor gradually becomes malignant, and finally can be transformed into meningeal sarcoma. Among benign meningiomas, hemangioblastoma is the most frequent malignancy. Malignant meningiomas can develop extracranial metastases, mainly to the lung (35% of cases), skeletal muscular system (17.5%), and liver and lymphatic system. Metastases may be related to surgical operations. In addition, tumor invasion of venous sinuses, skull, and scalp may also be the cause of metastasis. In addition, malignant meningiomas can also disseminate implantation via the cerebrospinal fluid. The average age of onset of malignant meningioma is significantly lower than that of benign meningioma. Tumors are mostly located in the convex surface of the brain and parsagittal sinus, and other sites, especially the posterior cranial fossa, are rare, so patients with malignant meningioma are more likely to have symptoms of neurological damage such as hemiparesis. Common symptoms of meningioma such as epilepsy and headache are common in malignant meningioma, but the course of the disease is shorter. The manifestation of malignant meningioma in CT is irregular tumor morphology, lobulated, may appear mushroom sign, unclear border, incomplete envelope, and uneven signal. Peripheral edema is obvious, and there is no calcification. The tumor is not uniformly enhanced after enhancement. T1 and T2 images of MRI show that malignant meningioma is high signal. Sometimes the blood supply from the internal carotid artery to the tumor is more obvious. Based on the clinical presentation, CT and MRI changes, the diagnosis of malignant meningioma is not very difficult as the diagnosis of meningioma. The treatment of malignant meningioma is surgical resection as the preferred method, even if the recurrence of malignant meningioma is available, it can be treated by surgery again. The invading skull and dura mater should be removed as much as possible during surgery, and dural repair should be performed after surgery. For the peritumoral brain tissue, electrocoagulation or laser irradiation can be done as much as possible, which is beneficial to reduce tumor residuals and prevent recurrence. It has been reported that radiotherapy or isotope intra-tumor radiation can be performed in order to effectively delay the recurrence time. For benign meningioma with recurrent recurrence, some people also advocate giving radiotherapy, which may be helpful to stop tumor malignancy and prolong recurrence time.