Spinal meningiomas, which are usually benign character, rarely show an invasive course. Since they grow slowly in the intradural extramedullary space, clinical symptoms also progress slowly. It is usually diagnosed in the later periods, when the tumor reaches to large size. They most commonly show location in the thoracic region. Although it does not have a real capsule, they can be removed completely or close to total by microsurgical methods, since they are well-demarcated solitary tumors. The most important factor in the complete and safe removal of spinal meningioma is the selection of the surgical approach suitable for the size, localization, and topography of the tumor. In the postoperative period, improvement in neurological functions is observed generally and their prognosis is good. In this study, the natural history of the tumor is explained in detail, by examining the pathogenesis and predisposing factors and clinical symptomatology in the spinal meningiomas. Moreover, it has been also focused on describing the surgical approaches and operative techniques to be used in the complete and safe removal of the spinal meningioma, according to the localization and topography of the tumor.