Long-term survival of malignant teratoma is rare. A 16-year-old female with a suprasellar malignant teratoma survived for 11 years before succumbing to embryonal carcinoma. A suprasellar immature teratoma with increased serum alpha-fetoprotein level was verified histologically. Radiation therapy and combined chemotherapy were given after partial removal. Eleven years later, the primary lesion recurred as embryonal carcinoma.