Objective To explore the feasibility processize strategy on clinical diagnosis of patients with meningeal carcinomatosis. Methods The clinical data of five patients with pathologically confirmed meningeal carcinomatosis in were rerospectively analyzed. And the development of meningeal carcinomatosis were reviewed. Results Five patients developed acute or subacute onset with or without tumor history. Clinical symptoms and signs were examined on meningeal nerve axis lesions， including the different degree of intracranial hypertension symptoms， signs of cranial nerve and spinal nerve damaged， and meningeal irritation signs. High pressure， biochemical data changes， and adenocarcinoma cells were found in CSF. The tumor marker CEA was high in all five cases. The multiple strip and nodositas intensified foci located in the meninges were displayed in MRI of one patient. Conclusions Symptoms and signs of meningeal nerve axis lesions are the basis of MC topical diagnosis. Finding tumor cells in the CSF with standardized test methods is an important way for pathological diagnosis of MC.