The usefulness of proliferation marker MIB1 in predicting recurrences in cranial meningiomas when other clinical and pathological factors are considered was assessed. Data from 65 patients with meningiomas were analysed and their clinical notes reviewed to define the Simpson grade of surgical excision, the location of tumour, amongst other clinical factors. The diagnosis was reviewed; immunohistochemical staining for a proliferation marker MIB1 was carried out on archival formalin-fixed, paraffin-embedded tumour and a labelling index for MIB1 (MIB1 L1) calculated. Analysis was undertaken of the impact of histology, grade of excision, tumour location and proliferation index on the risk of recurrence. The grade of surgical resection and histology type were the most important factors likely to predict recurrence. MIB1 LI was not considered useful in predicting tumour recurrence.