Background: Intracranial meningiomas (ICMs) make up 30-40% of all primary central nervous system malignancies. Aim: The research aimed to evaluate the neurocognitive outcomes within cases with skull base meningiomas, undergoing two surgical approaches Patients and methods: This randomized controlled double blinded clinical research has been performed on 85 patients diagnosed with perioptic meningiomas after their surgical excision by 2 different approaches. The first group included 42 patients in which intradural tumor excision was done after peeling of the outer layer of the lateral wall of cavernous sinus through the fronto-temporal approach and the second group included 43 patients in which intradural tumor excision was done without peeling of the outer layer of the lateral wall of the cavernous sinus.