We have investigated the effect of age on the outcome of first time surgery for intracranial meningiomas. In a retrospective study, 144 consecutive patients were divided into three groups: young (up to 44 years of age, 38 patients), middle-aged (45-64 years, 60 patients) and elderly (65 years and over, 46 patients). Outcome was assessed at the first follow-up appointment 4-6 months after discharge. The surgical mortality was 2.7%. The incidence of significant intercurrent disease increased with age (11, 25 and 35%, respectively), as did the incidence of postoperative complications (16, 23 and 30%). Postoperative intracranial bleeding was especially age-related, occurring in 20% of the elderly group as against 0% of the younger. Although the younger patients did best (100% in Glasgow Outcome Scale Grade 5) there was no difference in outcome between the middle-aged and elderly groups (88 and 83%, respectively). Of the elderly patients, 89% showed clear functional improvement after surgery, 2% were unchanged and 9% were worse or dead. The intellectual deterioration apparent in over half of the elderly patients recovered after removal of the tumour in 80%. We conclude that age has little effect on the prospects of success after removal of an intracranial meningioma.