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Abstract: Leptomeningeal metastasis (LM) of high grade gliomas (HGG) can lead to devastating diseasecourses. Understanding of risk factors for LM is important to identify patients at risk. We reviewedpatient records and magnetic resonance imaging (MRI) of all patients with a first diagnosis ofHGG who underwent surgery in our institution between 2008 and 2012. To assess the influence ofpotential risk factors for LM and the impact of LM on survival multivariate statistics were performed.239 patients with a diagnosis of HGG and at least 6 months of MRI and clinical follow-up wereincluded. LM occurred in 27 (11%) patients and was symptomatic in 17 (65%). A strong correlationof surgical entry to the ventricle and LM was found (HR: 8.1). Ventricular entry was documentedin 137 patients (57%) and LM ensued in 25 (18%) of these. Only two (2%) of 102 patients withoutventricular entry developed LM. Median overall survival of patients after diagnosis of LM (239 days)was significantly shorter compared to patients without LM (626 days). LM is a frequent complicationin the course of disease of HGG and is associated with poor survival. Surgical entry to the ventricle isa key risk factor for LM