Anterior skull base meningiomas are surgically accessible lesions, whose treatment of choice is the surgical resection. Nevertheless, there are a group of complex tumors, such as those attached to or encasing the optic apparatus and/or neurovascular structures in which total resection cannot be safely achieved. Nonetheless, when a meningioma is subtotally resected, progression rates average 60 % at 10 years. The use of ionizing radiation is an effective strategy to treat those tumors.