Objective To investigate the value of meningeal pathological examination in patients suspected of leptomeningeal metastasis.Methods A retrospective analysis was performed for 20 patients who were admitted to our hospital from March 2019 to July 2020 and were initially diagnosed with leptomeningeal metastasis， and meningeal tissue was collected for pathological examination during ventriculoperitoneal shunt， Ommaya capsule implantation， and external ventricular drainage.Results Among the 20 patients， 15 had abnormal results of meningeal biopsy， resulting in a positive rate of 75%， among whom 13 had leptomeningeal metastasis and 2 had glioblastoma and tuberculous meningitis， respectively. No complications associated with specimen collection were found in patients.Conclusion Meningeal pathological examination can improve the confirmed diagnosis rate of leptomeningeal metastasis and provide a basis for implementing precision radiotherapy and personalized chemotherapy. It is a simple， safe， and important method to make a confirmed diagnosis of leptomeningeal metastasis.