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Introduction-Meningiomas make up 18% of primary intracranial tumors and are twice as common in females. Pregnancy can reveal an undiagnosed intracranial tumor. Meningiomas, though benign, are influenced by progesterone and steroids, potentially increasing growth and symptomatic burden. This case illustrates the possible link and increased suspicion of a meningioma in women with history of prolonged progesterone exposure. Aims and objectives- Long-term progestin use is linked to increased meningioma risk, with over 60% expressing progesterone receptors (PR). Most meningiomas have high progesterone receptor (PR) expression, moderate androgen receptor (AR) levels, and low estrogen receptor (ER) levels, with PR positivity linked to symptom worsening. Case details ? A 36-year-old G2P1L1 with prior LSCS presented at 14+4 weeks gestation with recurrent GTCS episodes (5?8 minutes each). She had a history of long-term DMPA contraceptive use until 2 years ago and was on antenatal progesterone. USG showed a 14-week intrauterine gestation with normal growth, and MRI revealed a 5.7 ? 4.5 cm SOL in the left frontal cortex, causing lateral ventricle effacement. The patient was co-managed with neurosurgery, underwent meningioma excision with progesterone support, and achieved favorable neurological and obstetric recovery. Results ? Ideally, treatment during pregnancy focuses on symptom management to protect the fetus, with definitive treatment postponed until after delivery when possible Conclusion ?This case underscores the long term use of progesterone in symptomatic patients and a possible relation with meningioma which needs to be evaluated.There is need for a tailored, multidisciplinary approach to meningiomas in pregnancy, balancing symptomatic control with fetal viability.