Background: Parasagittal Meningiomas are a kind of intracranial tumour that must be treated surgically. Because of the wide range of symptoms that may accompany these tumours, choosing a course of therapy can be difficult. This research set out to compare several approaches to managing parasagittal meningioma, such as observation, microsurgery, and Gamma Knife Radiosurgery. Methods: This Over the course of two years, 39 patients participated in a prospective observational research. Microsurgical excision alone, microsurgical excision followed by adjuvant Gamma Knife Radio Surgery, and initial Gamma Knife Radio Surgery were the three therapy modalities used to categorise patients. In this study, we evaluated a number of clinical, radiological, and surgical factors. Results: Seizures was the primary presenting complaint regardless of therapy. The decision to use microsurgical resection alone or in conjunction with Gamma Knife Radio Surgery was strongly impacted by tumour size. The requirement for microsurgery and adjuvant radiosurgery increased in patients with SSS invasion. Surgical outcomes were tracked and evaluated with regards to Simpson grading, blood transfusion, and complications such vascular damage. The percentage of patients who had a recurrence of their tumour after surgery was recorded. Conclusions: The research showed that microsurgical intervention and gamma Knife radiosurgery, either alone or in combination, may be an effective treatment for slowing the progression of parasagittal meningioma, with fewer side effects than conventional chemotherapy and radiation.