The empty sella (ES) refers to an anatomic entity in which the pituitary fossa is partially or completely filled with cerebrospinal fluid. Descriptions of this entity relating to brain tumors not situated in the pituitary fossa have been rarely reported. We report a 55-year-old woman who presented with significant visual disturbance. A huge right frontal convex meningioma associated with ES was diagnosed. Tumor resection and simultaneous treatment of the ES by sellar arachnoid lysis and packing the sellar cavity improved her visual acuity significantly. We consider the ES to be primary and believe that tumor resection and ES treatment are equally important, which should be combined in 1 operation to reduce the intracranial pressure and reverse the optic nerve compression.