Objective: Complete and safe resection of sphenocavemous (SC) meningiomas is difficult and also a great challenge for neurosurgeons. The goal of our study was to report the surgical results and complications for these patients treated at our institution as well as trying to find the factors resulted in ptosis after the operation. Materials and methods: Forty-nine consecutive SC meningiomas cases that underwent surgery between April 1997 and December 2012 were reviewed. The clinical courses of all patients were recorded. Prognosis factors of post-operative ptosis were evaluated. Results: There were 38 female and 11 male patients. Mean duration of symptoms was 20.9 months. Visual deficit (34.7%) and headache (22.4%) were the most common presenting symptoms. Mean maximum diameter of the tumors on MRI was 5.1 cm. Subtotal resection was achieved in 51.0% of patients. Follow-up data were available for 39 patients, with a mean follow-up of 73.7 months, and four patients died during follow-up period. Of the 35 living patients, 22 (62.9%) lived a normal life. Univariate analyses showed that factors associated with post-operative ptosis included female patient, with primary operation and the cavernous extension in Category 3 of Hirsch' grading, while multivariate regression analyses showed that only the cavernous extension in Category 3 of Hirsch' grading was independently associated with post-operative ptosis. Conclusions: Our experience suggests that the most common complication after the SC meningioma surgery is ocular cranial nerve dysfunction, and the only significance factor relative to post-operative ptosis is the level of extension to the cavernous. (C) 2015 Elsevier B.V. All rights reserved.