Meningiomas are among the most frequent primary brain tumors, so knowing the association of different factors with the imaging recurrence of meningiomas is important for post-surgical decision-making. We conducted a retrospective analysis in six high specialty hospitals in Mexico with 190 patients diagnosed with meningiomas and who underwent resection surgery from 2009 to 2019. A univariate and multivariate analysis was performed to identify different risk factors, a simple linear regression analysis for quantitative variables, and a comparison of means to identify the impact of the different factors with the months of survival free of tumor recurrence. A total of 190 patients were analyzed, with an overall recurrence rate of 38.9% (74 patients). Regarding risk factors, the onset of intracranial hypertension syndrome was associated with a higher risk of tumor recurrence at follow-up. The simple linear regression analysis found that the greater the intraoperative bleeding, the lower the survival rate of tumor recurrence. In the comparison analysis of means, the intracranial hypertension syndrome and the petroclival location significantly reduced the months of free survival of the tumor recurrence. We report that a clinical presentation such as intracranial hypertension syndrome increases the risk of recurrence in meningiomas up to eight times more and that the greater the intraoperative bleeding, the lower the survival free of recurrence. © The Author(s), under exclusive licence to Indian Association of Surgical Oncology 2025.