Important studies have been reported in the past year on the biology and management of pediatric central nervous system tumors. Pediatric low-grade gliomas and adult gliomas do not share similar molecular genetic features. There may be a role for high-dose chemotherapy with bone marrow rescue in relapsed medulloblastoma and germinoma. Malignant gliomas in infants appear to be distinct entities compared with adult malignant gliomas. Further investigational studies are needed in ependymoma and diffuse pontine gliomas because current therapies have not resulted in improvements in outcomes.