A 57-year-old female patient with suspected extensive skull base meningioma presented for further diagnostic workup and consecutive treatment. High-resolution MRI shows a large mass arising from right sphenoid wing with unclear margins due to diffuse infiltration of the surrounding bony structures and the temporal muscle. An additional [68Ga]Ga-DOTA-TATE PET scan was performed and exhibited a high tracer uptake of the lesion, typical for a meningioma. The extent of vital tumor tissue in PET outranged the previously assumed tumor margins on MRI and therefore allowed for a more radical microsurgical tumor resection. In sum, the delineation of meningiomas in gold standard MRI alone can be challenging—e.g., due to osseous infiltration when located at the skull base. In such cases, somatostatin receptor targeted PET, e.g., using [68Ga]Ga-DOTA-TATE or [68Ga]Ga-DOTA-TOC, is a valuable complementary tool enabling a more comprehensive treatment planning, especially with regard to the choice of surgical approach and extent of resection.