Brain tumors are the second most common form of cancer in the pediatric age group. Surgical treatment is the mainstay of therapy for many brain tumors and is usually the first treatment given to children with brain tumors. Pediatric brain tumors differ from those of adults in many aspects: histological diagnosis, immaturity of the pediatric central nervous system, and the vulnerability of children to blood loss during the operation. The completeness of surgery is strongly associated with the prognosis of afflicted children, whereas surgical morbidities can be life-time deficits and handicaps for the children. Therefore, practicing pediatric neurosurgeons should combine a thorough knowledge on neuroanatomy and pathophysiology with state-of-the-art surgical skills and experience to obtain the best results. They should also take time for reflecting on the difficulties encountered and complications arising during operations.