The authors encountered a rare case of sphenoidal ridge meningioma associated with an arteriovenous malformation in the same cerebral hemisphere. A 65-year-old female was admitted to our service because of headache. X-ray computed tomography (X-CT) and magnetic resonance image (MRI) disclosed a huge mass with peripheral edema, diagnosed as a sphenoidal ridge meningioma. An associated small mass was also noted in the right parahippocampal gyrus. This was confirmed by angiography as an arteriovenous malformation (AVM). During the waiting period for surgical treatment she had fallen into coma abruptly. Emergency X-CT revealed intracerebral and intraventricular hematomas. Both lesions were resected successfully in a one stage operation. Postoperative course was uneventful. In general, AVM located in the medial temporal lobe is difficult to approach. However, in this case, the resultant large cavity obtained after removal of meningioma afforded us easy access to the AVM.