A retrospective analysis was performed on 23 patients with pineal region tumors treated with radiation from 1979 through 1985 at the Department of Therapeutic Radiology, Seoul National University Hospital, Histologic confirmation was done in only one case by surgical removal, and in the remaining 22 patients, the diagnosis was based on clinical and radiological findings. The radiation volume was the primary tumor site in 1 case, whole brain in 14 cases, and the whole craniospinal axis in 8 cases. The overall 5 year survival was 71.5%. The 5 year survival was 69. 3% for whole brain treated group and 73.3% for craniospinal axis treated group. The survival for the two groups did not differ significantly. In two cases sites of recurrence were detected. One in supratentorial area, and the other in the lung. The results from this retrospective analysis and the review of other reports indicate that routine use of prophlatic spinal irradiation is not warranted in pineal region tumor, and the craniospinal irradiation is recommended in cases with high risk for subarachnoid seeding such as positive CSF cytology, surgical removal or biopsy.