Meningeal metastasis refers to the distant metastasis of malignant tumor to the meninges, which can be divided into dural metastasis and leptomeningeal metastasis. With the prolongation of survival of patients with advanced breast cancer, the incidence of meningeal metastasis increases gradually. Due to the poor prognosis, meningeal metastasis patients are often excluded by most clinical trials, which leads to the lack of guidelines for early diagnosis and standard treatment, and makes it become an urgent clinical problem to be solved. In recent years, researchers have deepened their understanding of the mechanism of meningeal metastasis, diagnostic techniques such as circulating tumor cells and free tumor DNA in cerebrospinal fluid have been gradually developed, and clinical trials related to meningeal metastasis treatment have been carried out, which has resulted in a breakthrough in the management of meningeal metastasis of breast cancer. In this paper, we discuss the mechanism, diagnosis, and treatment of breast cancer meningeal metastasis.