Significant advances were achieved in the past two decades in the management of brain tumors in children. However there are many challenges that still remain. In tumors like medulloblastoma where there has been considerable success, attempts are in progress to reduce the toxicities of the therapies. Patients with high-grade gliomas pose a considerable challenge and current therapies for these tumors are minimally effective. Patients with low-grade gliomas also pose a considerable challenge based on the age at presentation, location and resectability. Advances in the biology of the low and high-grade glial tumors may offer insights into their behavior and management. Management of patients with ependymoma has evolved over the years with increasing emphasis on radiation therapy. These tumors are sensitive to chemotherapy but the role of chemotherapy is yet to be defined. New findings in the biology of ependymoma will lead to better understanding of the disease and its management.