Chen, 33, had been treated as migraine in an outside hospital for long-term intractable headache, but the effect was not obvious. After coming to our hospital, it was found that the patient’s headache was mainly occipital and posterior neck pain. Combined with the medical history, it was thought that Chen did not have a simple migraine, but probably a headache secondary to cervical-occipital lesions. Finally, the patient was diagnosed by MRI as a right anterior meningioma of the medulla oblongata in the foramen magnum region. Due to the deep location of the tumor in the occipital foramen, it is close to the brainstem, cervical medulla, vertebral artery, posterior group of cranial nerves and other important tissues, blood vessels and nerve structures, and it is where the center of life is located, which is very rich in blood flow. And any small intraoperative failure may make the patient either dead or disabled. Therefore, the treatment of tumors located in this region, especially in the ventral part of the brainstem, has always been one of the challenges faced by neurosurgeons. Surgery in this region aims to achieve total resection of the tumor without compromising the patient’s long-term quality of life. The surgery is difficult and risky, requiring the surgeon to have extensive knowledge of neurosurgical anatomy, skillful surgical techniques and rich surgical experience. The patient was admitted to the hospital and underwent the surgery soon after completing the relevant examinations. The tumor was completely removed by using the distal lateral approach. The headache that had been bothering him for a long time also disappeared.