Abstract： Objective:To assess the efficacy of resection of pineal region meningiomas through occipital interhemispheric approach.Methods:We retrospectively reviewed the clinical records of 10 patients with pineal region meningiomas who underwent microsurgical resection via occipital interhemispheric approach between May 2010 and November 2021 at the Department of Neurosurgery of the First Affiliated Hospital of Air Force Military Medical University. The maximum tumor diameter was 4.4±1.4 cm (2-7 cm). Among the 10 patients, there are 9 cases of falcotentorial meningiomas and 1 case of velum interpositum meningioma. According to the Bassiouni classification system, there are 4 cases of type Ⅰ, 4 cases of type Ⅱ, 1 case of type Ⅲ and 1 case of type Ⅳ. Extent of resection and postoperative complications were also assessed.Results:Ten patients with pineal meningioma underwent 11 surgical operations. Of the 11 operations, 9 were Simpson grade Ⅱ resection, 1 was grade Ⅰ and 1 was grade Ⅳ. Transient homonymous hemianopia occurred in 3 patients after operation and recovered in 1 week. One patient had hemiparesis, which resolved by 3 months. No patient suffered from tumor recurrence or died, with a median follow-up of 38 months (4 months to 12 years). At the last follow-up, the KPS score was ≥80 in 8 cases and 50-70 in 2 cases.Conclusion:Through the occipital interhemispheric approach, the pineal region meningiomas occupying the infratentorial space can be accessed effectively by opening the tentorium or the falx cerebri. The degree of tumor resection is relatively high with few complications.