Pilocytic astrocytoma (WHO Grade 1) is a low-grade glioma with a favorable prognosis most commonly diagnosed in patients aged below 20. It is the most common glioma in children, and cases discovered in elderly patients are rare. We report the highly unusual case of an 85-year-old man whose neurological signs included Parkinsonism, and in whom post mortem examination revealed a pilocytic astrocytoma of the brainstem. We also discuss the clinical, neuroradiological and neuropathological differential diagnosis.