This study describes the management of and outcomes for adult and paediatric patients with newly diagnosed brain stem gliomas during 1998-2000 in Victoria. Adult patients were identified in a retrospective cohort study conducted by surveying doctors involved in managing incident brainstem glioma cases identified from the population-based Victorian Cancer Registry. Paediatric cases were identified from a retrospective analysis of the Victorian Paediatric Brain tumour database for the same period. Ten adult and 14 paediatric patients were considered eligible for this study. Nine (38%) did not have a histologic diagnosis but were diagnosed on the basis of radiological appearance. Complete macroscopic resection was performed in two patients (8%). A variety of tumour types and grades were observed with surgery and radiotherapy the mainstays of therapy. No adult patients and only eight (57%) paediatric patients received chemotherapy. The median survivals for adult patients, paediatric patients with pontine lesions and paediatric patients with non-pontine lesions were: 57, 10 and 60+ months respectively.