The current treatment of children with malignant brain tumors is reviewed. Multidisciplinary treatment is essential for malignant gliomas or glioblastoma. The prognosis of children with glioblastoma remains dismal and a new treatment approach needs to be established. Recent aggressive multi-drug chemotherapy in combination with radiotherapy and surgery have markedly improved the treatment of children with medulloblastoma and primary intracranial malignant germ cell tumors. The number of long-term survivors and even cure rates have been increasing.