Abstract: Objective To improve the diagnostic level and surgical curative effect of the intracranial cholesteatoma. Methods Analyse and summarize the clinical materials included the clinical main manifestations,diagnostic modes,microsurgical approach,and outcome of 218 patients with the intracranial cholesteatoma. Results There were 203 cases(93.1%)total removal of the tumor.In the remaining 15 patients(6.9%),adhesion tightly to the thalamus or brain stem made only subtotal removal of the capsule of tumor. 5 patients were died(2.3%)because of brain stem ischemia or edema,and lung infection within two weeks postoperatively.Long-term follow-up review(mean 5.6 years)in 176 patients revealed good recovery of 170 patients(96.6%),contrasted with a 1.7%(3 cases)late recurrence rate after operations.This patients with recurrence of tumor need to treat by again operative management. Conclusion It is effective method by using the CT or MRI to diagnose and microsurgical technique to remove cholesteatoma for these patients.