Meningiomas are mostly benign, slow-growing central nervous system tumors that can have malignant remodeling in about 1–3% of cases. Due to newer advancements in diagnostic imaging, emerging role of positron imaging, role of molecular markers, better surgical and radiation techniques and systemic treatments for recurrent disease, the overall survival of patient is improving. Genomic studies include NF2 tumor suppressor gene on chromosome 22q12.2, TRAF7/KLF4 (secretory type), AKT1, SMO (Smoothened), SUFU, and POLR2; TERT mutations; and H3K27me3 loss, which help in depicting the prognosis. Newer technologies such as 68 Ga-DOTA PET help in the detection of tumor in recurrent settings and in the diagnosis of optic nerve sheath meningiomas. The newer state-of-the-art external beam radiation techniques are helpful in proper meningioma management. Different radiation guidelines help in proper delineation of tumor which has further optimized the treatment. Apart from use of photons, the use of particle ions like protons and carbon ions have helped in escalating the dose of radiation in selected cases. However, evidence-based clinical trials are lacking which can refine radiation therapy delivery in completely resected atypical meningiomas. Thus, multi-disciplinary collaborative efforts, new clinical trials, dose escalation data are essential for the proper treatment of meningiomas.