Objective To elucidate the diagnosis and surgical treatment of the posterior fossa solid hemangio~blastomas (PFSHs) Methods The data from 22 patients with PFSHs verified by surgery and pathology were analyzed retrospectively and a review of relevant literature was conducted Results The preoperative definitive diagnosis rate was 13/22 Total tumor removal was achieved in 20 patients Two of the 22 patients died after surgery, one of brain stem injury and the other from an intracranial hemorrhage Twenty patients were followed up for 2 months to 8 yeas (average, 2 years) Karnofsky scale was 80 in 15 patients, 60-70 in 1 patient and not measured in 4 patients who died during follow up The causes of death were pneumonia (2 patients) and purulent meningitis (2) Conclusion MRI and DSA (digital subtraction angiography) are major preoperative diagnostic modalities for PFSH, but PFSH remains a challenging benign neoplasm Special microsurgical techniques and improved operative manipulation can improve surgical efficacy Objective To elucidate the diagnosis and surgical treatment of the posterior fossa solid hemangio ~ blastomas (PFSHs) Methods The data from 22 patients with PFSHs verified by surgery and pathology were analyzed retrospectively and a review of relevant literature was entitled Results The preoperative definitive diagnosis rate was 13/22 Total tumor removal was achieved in 20 patients Two of the 22 patients died after surgery, one of brain stem injury and the other from an intracranial hemorrhage Twenty patients were followed up for 2 months to 8 yeas (average, 2 years) Karnofsky scale was 80 in 15 patients, 60-70 in 1 patient and not measured in 4 patients who died during follow up The Causes of death were pneumonia (2 patients) and purulent meningitis (2) Conclusion MRI and DSA (digital subtraction angiography) are major preoperative diagnostic modalities for PFSH, but PFSH remains a challenging benign neoplasm Special microsurgical techniques and improve opera tive manipulation can improve surgical efficacy