The clinical features and pathological materials of 51 cases of histologically verified meningiomas in patients under 21 years of age were reviewed. The age range was 7 to 20 years, with the majority of cases being clustered in the second decade of life. There was virtually a 1:1 sex ratio, with 26 females and 25 males. Thirty-eight patients had intracranial meningiomas, three had intraorbital tumors, and 10 had intraspinal tumors. Twelve patients (24%) had neurofibromatosis. Twenty patients (39%) had tumor recurrence. The cases were subdivided into five histological categories: meningotheliomatous, fibrous, transitional, psammomatous, and papillary. In each case, the clinical course was correlated with histological subtype. The 15-year survival rate in patients with intracranial meningiomas of all types was 68%. Factors adversely affecting survival included infratentorial location, papillary histology, and evidence of brain invasion.