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Uludağ Üniversitesi, Tıp Fakültesi, Nöroşirürji Anabilim Dalı, 16059, Bursa, Türkiye Olfactory groove meningiomas comprise approximately 10% of meningiomas. These tumors are midline lesions that derive their blood supply from the ethmoidal branches of the ophthalmic arteries, the anterior branch of the middle meningeal artery, and the meningeal branches of the internal carotid artery. Early devascularization of these tumors is the first step in tumor removal. A low basal approach is preferred with a unilateral supraorbital craniotomy or midline bifrontal craniotomy usually being sufficient for optimal access. The anterior cerebral arteries and their branches, as well as the optic nerves and chiasm are the neurovascular structures at greatest risk during the surgical removal of giant olfactory groove meningiomas. The anterior cerebral artery complex and optic system are typically displaced and fine microdissection is required to free these structures. Inspection of both olfactory grooves is necessary to detect tumor residue in this area. Reconstruction with a vascularized pericranial galea (periosteal flap) to prevent cerebrospinal fluid leakage is essential. Anahtar Kelimeler : Olfactory groove meningiomas, Surgical approaches