Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder with variable expression. The complications are age specific. Neurologic complications include tumors of the peripheral nerves, nerve roots, and plexi; spinal cord compression; dural ectasias; learning disabilities; attention deficit; headaches; seizures; brain tumors; deafness; hydrocephalus; and stroke. High-intensity signals on brain magnetic resonance imaging are a frequent finding without known clinical significance. Most brain tumors are benign and asymptomatic, but malignant brain tumors occur. The major cause of death is malignancy, including brain tumors and malignant peripheral nerve sheath tumors. Management includes genetic counseling, regular eye examinations, and careful physical exams.