We retrospectively reviewed 38 cases of low-grade non-pilocytic astrocytoma diagnosed at the Charleston Area Medical Center between 1957 and 1987. All patients underwent craniotomy (total resection in 8 and subtotal in 24) or stereotactic needle biopsy (6 patients). Twenty-eight patients (74%) received radiotherapy, 25 of whom received > or = 5,000 cGy. The median survival of all patients was 46 months and nine patients (24%) survived > or = 5 years. Patients under age 40 had a longer survival than those age 40 or older (59 months vs. 30.5 months, p < .05). There was no significant difference in mean survival between those who received and those who did not receive radiotherapy after incomplete surgical resection (49 months vs. 53 months, p = 1.00). Of the 29 deaths, 15 were due to malignant transformation to a high-grade glioma and 12 to recurrent low-grade glioma. Since the role of radiotherapy is unclear, it is important that patients with low-grade glioma participate in clinical trials.