Objective To investigate the strategy of skull base reconstruction after resection of meningioma communicating the orbit and middle cranial fossa. Methods A retrospective review was carried out of the clinical data of 72 patients who underwent microsurgical operations by orbito-peronal approach for cranio-orbital communicating skull base meningioma in this department between Jan 2007 and May 2012. Then the method of skull base reconstruction after tumor resction was discussed. Result In this series, skull base reconstruction including dural repair and cranioplasty resulted in satisfactory outcome. The complication such as cerebrospinal fluid leakage, meningocele, meningitis etc. did not occur . Subcutaneous hydrops came out in 12 cases. Conclusions Microsurgical resection by orbito-peronal approach is a favorable treatment for this kind of cranio-orbital tumors. Skull base reconstruction is one of the key to the successful surgery.