Objective: We evaluated the microsurgical effects of intratumoral injection ethanol into intracranial tumors, in particular, those with highly vascularized large meningiomas. Methods: Twelve patients presented with large meningioma, anhydrous ethanol was intraoperatively injected at an average volume of 15.4 mL followed by microscopic tumor resection. Results: Tumors in the injected sites became pallor to various extent and sclerous, leading to significantly decreased hemorrhage on the surface and cut. The average intraoperative hemorrhage was 88 mL. Complete tumor resection was achieved in 11 out of 12 patients; however, only 1 patient had 91.6% of the tumor resected. None of these patients had any postoperative complications. Conclusion: Intratumoral injection of anhydrous ethanol is a safe, convenient, and effective approach to diminish intraoperative bleeding for highly vascularized large meningiomas. © Huazhong University of Science and Technology and Springer-Verlag Berlin Heidelberg 2010.