Objectives: To study the clinical characteristics and microsurgieal technique of sylvian fissure meningiomas.Methods: we retrospectively analyzed 6 patients and reviewed the literature with regard to the incidence,clinical manifestations,imaging features,microsurgical anatomy,and postoperative outcomes of sylvian fissure meningiomas,and the technical aspects of their treatment.Results: The tumors were iso-to hyperdense on CT scans.While on MRI scans,they were iso-to hypointense on T l-weighted images and iso-to hyperintense onT2-weighted images,with intense and mainly homogeneous contrast enhancement.After administration of a contrast agent,T1WI revealed well-demarcated enhancing masses that were intimately attached to the middle cerebral artery and its branches in the sylvian fissure.All the patients underwent either gross total (n=3) or sub-total resection (n=2) of the lesions.There was no operative mortality.Post-operative complications included hemiparesis (n=4) and aphasia (n=2).Conclusions: The surgical approach to sylvian fissure meningiomas is a prime determinant of outcome following tumor resection.Trans-sylvian approach is a better choice in handling with these tumors.Making an appropriate approach largely depends on making a correct preoperative diagnosis.Meningioma should be included in the preoperative differential diagnoses of patients with well-demarcated enhancing mass lesions in the sylvian fissure region.