This communication describes one pediatric neurosurgeon's personal view of the neurosurgical perspectives in pediatric neurooncology. Various roles of surgery, including histological verification, maximum cytoreduction, neurodecompression and restoration of the cerebrospinal fluid pathway, are emphasized. A pediatric neurosurgeon, who is the first person to make decisions on diagnosis and treatment relating to children with brain tumors, should be up to date with advances in diagnostic and therapeutic methods. Particularly, he or she should be familiar with both the efficacy and the side effects of radiation therapy and chemotherapy to allow selection of the optimum treatment for such children.