〔Abstract〕 Objective To investigate the correlation between the types of feeding arteries and the estimated blood loss (EBL) during preoperative arterial embolization (PAE) combined with surgical resection of meningiomas. Methods A retrospective analyzed of 27 patients underwent PAE combined with surgical resection of meningioma in Shenzhen Second People's Hospital from April 2012 to August 2018. Increased the blood contribution of the Manelfe classification of the vertebral and basal artery system, and discussed the correlation between the degree of blood contribution and the degree of hemorrhage. Results Among the 27 patients with meningioma combined with PAE, 6 patients (22.2 %) still had massive hemorrhage during operation. The modified Manelfe classification was an independent risk factor for EBL > 600 mL (P < 0.05). There was significant difference in the complete tumor embolization rate between the two groups with type Ⅰ, Ⅱ and Ⅲ, Ⅴ (P < 0.05). Conclusion The modified Manelfe blood supply classification is an independent risk factor for meningioma PAE combined with surgical resection of EBL > 600 mL, and it can be used to evaluate the degree of tumor embolization and intraoperative bleeding, then gradually weakened.