Over a two year interval, we have treated five children with neurofibromatosis who developed brainstem gliomas. They had an insidious onset of symptoms and other indicators of low grade tumor despite several features that have been ascribed to rapidly progressive brainstem gliomas. Following standard radiation therapy a more protracted improvement was observed with the persistence of preradiation findings for several months. This experience confirms the better prognosis in brainstem glioma associated with neurofibromatosis.