Introduction: Patients with cavernous sinus meningiomas (CSM) have an elevated risk of surgical morbidity and mortality. Recurrence is often observed after partial resection. Stereotactic radiosurgery (SRS), either alone or combined with surgery, represents an important advance in CSM management, but long-term results are still lacking. Methods and Materials: A total of 98 CSM patients, treated from January 2000 to December 2013, were retrospectively reviewed. The mean follow-up was 86.8 months (range = 17.1–179.4 months). Among the patients, 15 were followed for more than 10 years. There was a female predominance (75.46%). The age varied from 24 to 79 years (mean = 49.6). From all, 98 patients, 57 (53.4%) received SRS alone, and 41 patients (46.6%) had undergone surgery before Gamma-knife surgery (GKS). A dose of 14 Gy was prescribed to isodose curves from 50% to 90%. In 25 patients (28.4%), as a result of the proximity to organs at risk, the prescribed dose did not completely cover the target. Results: After GKS, 53 (51.9%) patients presented with tumor volume reduction; 36 (35.2%) remained stable, and 9 (8.8%) had tumor progression. The progression-free survival was 87.23% at 5 years, and 79.5% at 10 years. Age, sex, maximal diameter of the treated tumor, previous surgery, and complete target stereotactic radiosurgery can control tumor growth if the whole mass can be irradiated by dosages of more than 14 Gy. When optimal radiosurgical planning is not feasible because of large size, irregular shape, or proximity of the tumor to visual pathways, the use of limited surgical resection before radiosurgery is the best option, and should provide sufficient long-term tumor control with minimal complications.