A case of deep sylvian meningioma is reported which is unusual in the aspect that the initial symptoms were headache and vomiting due to intracerebral hemorrhage from meningioma. After evacuation of hematoma in the right temporal lobe and biopsy of the tumor, it was found to be meningothelial meningioma with psammoma bodies. Cerebral angiography showed characteristic findings of intrasylvian vascular tumor. Complete removal of this tumor was performed under microscopy, dissecting dense adhesion between the tumor and main branches of the middle cerebral artery. Consequently, the patient showed only slight impairment of fine movement of his left fingers. Deep sylvian meningioma designated by Cushing and Eisenhart is very rare. This case is the only one of deep sylvian meningioma in our whole series of 181 intracranial meningiomas and probably the twentieth case reported so far in the literature.