Background: Tumors of the cauda equina usually require surgery due to their impingement on neighboring nerve roots, often resulting in pain and neurological deficits. Method: The Authors first give a brief introduction on cauda equina tumors, followed by a description of the surgical anatomy, and then develop the microsurgical technique. In particular, tricks to avoid complications are presented, underlining the importance of intraoperative neuromonitoring. Conclusion: Both microsurgical technique and neuromonitoring are important in cauda equina tumor surgery, the goal of which is to achieve complete resection while at the same time preserving neurological function.