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Risk factors to predict late-onset tumor recurrence in meningioma patients are urgently needed to schedule control intervals during long-term follow-up. We therefore analyzed the value of established risk factors for postoperative meningioma recurrence for the prediction of long-term prognosis. Correlations of clinical and histopathological variables with tumor relapse after 3, 5, and 10 years following microsurgery were analyzed in uni- and multivariate analyses, and compared to findings in the entire cohort. In the entire cohort (N = 1218), skull base location (HR: 1.51, 95%CI 1.05–2.16; p =.026), Simpson ≥ IV resections (HR: 2.41, 95%CI 1.52–3.84; p <.001), high-grade histology (HR: 3.70, 95%CI 2.50–5.47; p <.001), and male gender (HR: 1.46, 95%CI 1.01–2.11; p =.042) were independent risk factors for recurrence. Skull base location (HR: 1.92, 95%CI 1.17–3.17; p =.010 and HR: 2.02, 95%CI 1.04–3.95; p =.038) and high-grade histology (HR: 1.87, 95%CI 1.04–3.38; p =.038 and HR: 2.29, 95%CI 1.07–4.01; p =.034) but not subtotal resection (HR: 1.53, 95%CI.68–3.45; p =.303 and HR: 1.75, 95%CI.52–5.96; p =.369) remained correlated with recurrence after a recurrence-free follow-up of ≥ 3 and ≥ 5 years, respectively. Postoperative tumor volume was related with recurrence in general (p <.001) but not beyond a follow-up of ≥ 3 years (p >.05). In 147 patients with a follow-up of ≥ 10 years, ten recurrences occurred and were not correlated with any of the analyzed variables. Skull base tumor location and high-grade histology but not the extent of resection should be considered when scheduling the long-term follow-up after meningioma surgery. Recurrences ≥ 10 years after surgery are rare, and predictors are lacking. [ABSTRACT FROM AUTHOR]