The evidence obtained in the last 15 years has shed new light on the functioning of the brain tissue in norm and pathology. It has been shown that proliferating stem cells exist in the adult brain. Under certain conditions, these cells can participate in posttraumatic repair, replacing perished cells. The involvement of stem cells in the development of malignant tumors have been established. Numerous genomic mechanisms of regulating self-renewal of neural stem cells, their proliferation and differentiation have been found. These findings open new avenues in studying brain functions and development. They are used for designing cardinally novel technologies for treating neurogenerative diseases and brain cancers. In this review, we present new evidence on the genomic mechanisms involved in governing the fate of neural stem cells in vivo and in vitro.