The management of high-grade or relapsed/aggressive meningioma is very difficult, and no effective treatment has been established so far for this disease. BNCT might offer a chance to obtain better results for high-grade meningiomas. The rationale for BNCT for high-grade meningioma was that there was relatively high accumulation of boronophenylalanine (BPA) as well as BSH. The treatment of meningiomas with BNCT has been discussed for a very long time. However, there have been only a small number of the cases reported/series published in the literature, but high-grade meningiomas showed good local response to BNCT. BNCT is one of the candidates for an effective treatment for these aggressive meningiomas. BNCT could control the local tumor well; however, some cases are rarely occurring systemic metastasis and CSF dissemination, and die because of these pathologies. Further development of BNCT for high-grade meningiomas will be required, similar to malignant gliomas.