Objective To investigate the effects of the selection of surgical approaches of lateral ventricular meningiomas and microsurgical skills on postoperative efficacy and complication rate. Methods The clinical data of 47 patients with lateral ventricular meningioma operated at the Department of Neurosurgery, Tianjin Huanhu Hospital from October 1 2006 to October 1 2014 were analyzed retrospectively. The patients were treated via parietooccipital approach (n=38) and temporal gyrus cortex approach (n=9) according to the different locations and directions of tumors. Thirty-two of them used neuronavigation and 26 used intraoperative ultrasound technology. Results Thirty-eight patients were treated via parietooccipital approach, the tumors of 37 patients were resected totally (Simpson grade Ⅰ), and 1 was resected subtotally (Simpson grade Ⅳ). Nine patients were treated via temporal gyrus approach and their tumors were resected totally. The symptoms of intracranial hypertension of 30 patients were relieved with varying degrees after procedure; the symptoms of hemianopsia of 9 patients were improved after procedure, 2 aggravated, and 1 was a new case; ataxia and other movement disorders of 8 patients were improved; 2 patients underwent ventricle-peritoneal shunt and puncture drainage respectively because of hydrocephalus. In this group, 29 patients were followed up for 3 months to 8 years (mean 47 months) after procedure. Two patients had recurrence and were reoperated. Conclusions Lateral ventricle meningioma prefers surgical treatment. Choosing appropriate surgical approaches with the help of neuronavigation and intraoperative ultrasound and other techniques may decrease the postoperative complication rate and achieve good operation effect. Key words: Meningioma; Lateral ventricle; Approach, surgical; Complication; Neuronavigation