A brain tumor associated with an arteriovenous malformation (AVM) is very rare. A 36 yr old female presented with two separate lesions, one in right front parietal (FP) and other in left FP area on MRI. The right side lesion was a tumor and the left side was an AVM. The right side lesion was removed first and was a meningioma, the left side lesion was an AVM and was observed. As it was Spetzler Martin grade - 4 without bleeding. We discuss the operative strategy in case of synchronous disease and review of literature.