Abstract： Objective To study the removal technique and operative experience in the microsurgieal resection of petroclival meningiomas by trans-suboccipital retresigmoid suprameatal approach ( TSRSA), to improve the rote of total resection of tumors and the postoperative results. Methods The consecutive twenty-three eases of petroclival meningiomas treated from Jan. 2003 to Jun. 2007 by microsurgical technique using standard TSRSA were reviewed retrospectively. The maximum diameter of the tumors ranged from 1.8 to 5.7 cm ( mean 3.9cm). The main parts of all tumors were located in posterior fossa. The tumor control rate, postoperative neurological deficit and functional status were assessed by Kamofsky Performance Score (KIXS) to evaluate the indications, advantages and disadvantages of TSRSA. Results The gross total tumor resection was achieved in 19 patients (83%) ,subtotal in 4 cases( 17% ). The new functional deficit of cranial nerves were found in 3 patients ( 13% ). There was no mortality with relation to operation or decrease in KPS was observed at the discharge. One case was complicated by midbrain hemorrhage, one ease with subcutaneous hydrocele. Conclusion This approach is suitable for petroclival meningiomas mainly in posterior fossa with extension to middle fossa (type Ⅱ ) to improve the rate of total resection of tumors and the postoperative results, and to decrease the postoperative functional deficit of cranial nerves.