| Summary: | Background: Explosive growth of intracranial meningioma during pregnancy is rare and poses significant surgical and anesthetic challenges. The current paper aims to describe cesarean section (CS) and craniotomy in one anaesthesiologic setting and enumerate the challenges encountered in such rare entities in neurosurgery. Case presentation: The authors report a pregnancy-associated giant intracranial meningioma, which underwent CS at 37 weeks of gestational age followed by emergent craniotomy in the same setting because of the mass effect and progressive lower limb weakness. To our knowledge, this is the second successful case in contemporary literature without any morbidity. Conclusion: Several strategies have been elucidated for intracranial tumors during pregnancy; however, no evidence-based protocol is currently available. The plausible recommendation is a CS as the first surgery and the neurosurgical intervention when the patient's neurological status and gestational age allow.
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