Background - Anterior lumbar- sacral meningocele is an uncommon type of spinal dysraphism, which can occasionally be linked to syndromes like Currarino and Marfan syndromes. While neurological complications are infrequent with these lesions, secondary conditions such as meningitis, sepsis, obstetric issues, and bowel and bladder difficulties are frequently observed. Surgical intervention is the established treatment approach for symptomatic or enlarging masses since these lesions do not typically resolve spontaneously. Repairing the dural defect can be achieved using either anterior or posterior surgical approaches. Aims and Objectives - The objective of this investigation was to diagnose individuals exhibiting symptoms related to large anterior lumbar-sacral meningocele and to examine the management difficulties and outcomes associated with these tumors. Material and Methods - This retrospective study included two patients admitted with radiologically diagnosed anterior lumbar-sacral meningocele under department of neurosurgery, GRMC and associated J.A. group of Hospitals from May 2013 to November 2022 who underwent surgery. No randomisation done. Results - The primary objective in the management of anterior lumbar-sacral meningoceles is the complete cessation of communication between the spinal subarachnoid space and the meningocele. Several reported procedures encompass the posterior approach involving sacral laminectomy and ligation of the neck of the anterior sacral meningocele, the transabdominal approach with meticulous suturing of the neck of the meningocele, the perineal approach, and the utilisation of lumboperitoneal shunt insertion in instances where surgical closure proves ineffective for large fistulas. Conclusion- In general, patients diagnosed with anterior lumbar-sacral meningocele exhibit favourable prognosis and surgical outcomes. Surgical closure is considered the optimal therapeutic strategy for addressing anterior lumbar-sacral meningoceles, primarily due to their inherent lack of spontaneous regression and inclination towards progressive enlargement, which increases the risk of complications. However, it is important to acknowledge that surgical intervention for anterior lumbar-sacral meningoceles presents demanding and challenging circumstances. The intricate nature of the procedure, coupled with the rarity of these defects, contributes to the surgical complexities associated with their management. [ABSTRACT FROM AUTHOR]