The high incidence of meningiomas in women indicates the role of female sex hormones in the growth of meningiomas. The use of hormonal contraceptives has been associated with an increased risk of meningiomas. Prior studies have reported an association between hormonal contraceptive use and the expression of certain hormonal receptors in meningioma tissues in which expression of progesterone and estrogen receptors have been associated with histopathological grading of meningiomas. There have been no previous studies about the association between hormonal contraceptive use and the histopathological grading of meningiomas. The aim of this study was to evaluate the association between hormonal contraceptive use and histopathological grading of meningioma. This study was an analytic cross-sectional study conducted at Mohammad Hoesin General Hospital Palembang and enrolled female meningioma patients with a history of hormonal contraceptive use from January 1st, 2018, to December 31st, 2020. Data were collected from medical records and in person or by phone interview. From 220 meningioma patients, 72 subjects were included in this study with 79.2% were low grade meningioma and 20.8% were high grade meningioma. Among the current users, 66.7% had high-grade meningioma, while 60.0% of combined hormonal contraceptives, and another 60.0% long-term users had high-grade meningioma, respectively. The status of hormonal contraceptive uses (p = 0.038) and the type of hormonal contraceptive (p = 0.001) had a significant association with the histopathological grading of meningioma and became the most significant independent variables according to multivariate logistic regression (p = 0.034; OR: 4.433 and p = 0.001; OR: 9.686) while there was no association between duration of use and histopathological grading of meningioma (p = 0.180). Current users and combination contraceptives (estrogen and progesterone) increased the risk of high-grade meningioma.