Objective To observe the clinical characteristics of cystic meningioma and risk factors for epilepsy secondary to microsurgery， and provide a scientific reference basis for clinical disease treatment and improvement of patient prognosis. Methods The baseline data of 105 patients with cystic meningioma admitted to Mianyang Central Hospital from February 2018 to April 2021 were included in the retrospective analysis. Patients with epilepsy after microsurgery were included in the development group (55 cases), and those without epilepsy were included in the non-development group (50 cases). Recorded and compared two groups of patients with baseline data, may affect the cystic meningioma patients postoperative seizure of microscopic multiple factors, using multivariate Logistic regression analysis of cystic meningioma microscopic surgery in patients with secondary epilepsy risk factors. 〗Results After analyzing the clinical characteristics of the 105 patients with cystic meningioma enrolled, the results showed that the patients especially had headache as the main manifestation accounting for 46.67%, followed by weakness of extremities, headache with weakness of extremities, and epilepsy symptoms with prominent performance, accounting for 17.14%, 12.38%, and 12.38%, respectively. The 105 patients with cystic meningioma enrolled in the group had 55 cases of epilepsy after microsurgery, accounting for 52.38% (55/105), which were included in the occurrence group, and 50 cases without epilepsy, accounting for 47.62% (50/105), which were included in the non-occurrence group. The age, location of the lesion, preoperative epilepsy history, tumor diameter, perioperative prophylaxis, tumor resection, tumor cavity bleeding, intraoperative Age, lesion location, preoperative epilepsy history, tumor diameter, perioperative prophylaxis, tumor resection, tumor cavity bleeding, and intraoperative cortical or vascular injury were used as independent variables and assigned values, and whether epilepsy occurred after microsurgery in patients with cystic meningioma was used as the dependent variable (1=occurred, 0=did not occur). The results showed that age, lesion location, preoperative epilepsy history, tumor diameter, perioperative prophylaxis, tumor resection, tumor cavity bleeding, and intraoperative cortical or vascular injury were all influential factors in the occurrence of epilepsy after microsurgery in patients with cystic meningioma (OR>1, P<0.05). Conclusion Age, lesion location, preoperative epilepsy history, tumor diameter, perioperative prophylaxis, tumor resection, tumor cavity bleeding, and intraoperative cortical or vascular injury are all closely related to the occurrence of epilepsy after microsurgery in patients with cystic meningioma. The aim is to reduce the risk of epilepsy and promote a favorable prognosis in patients with cystic meningioma.