Significant work has been published over the past year on the management of childhood primary central nervous system tumors. Chemotherapy is taking on an increased role in the treatment of children with medulloblastoma and low-grade gliomas and infants with malignant tumors. Although survival remains poor for children with brain stem gliomas, even after treatment with high-dose radiotherapy regimens, subsets of patients have been identified who have a more favorable prognosis. Neurocognitive dysfunction remains a significant treatment outcome in children surviving brain tumors.