Traditional histologic pathology relies on cytomorphology to classify and define glioma grading. In clinical practice, it has been found that gliomas with identical or similar tissue characteristics can have widely varying prognosis, indicating that relying on histologic typing alone to classify gliomas is still flawed. Studies have shown that having different molecular features is responsible for the large prognostic differences in patients with the same histologic staging of glioma. Molecular pathology-based glioma staging can more accurately classify and predict the clinical prognosis of gliomas; it can also help clarify the diagnosis and grading of mixed gliomas that are histologically difficult to identify, such as oligodendrocytomas. The newly discovered molecular variants have the potential to become new targets for future treatment. After years of exploration and accumulation, the pathological diagnosis of glioma has entered the era of molecular diagnosis since 2016, and a diagnostic model combining histological typing and molecular typing (integrated diagnosis) has been established. The integrated diagnosis combines the histological features of glioma and molecular typing, which can classify glioma with relative accuracy and better guide treatment and prognosis, and is an important basis for diagnosis and grading of glioma. Despite several years of molecular diagnosis and treatment, there is no breakthrough in improving the prognosis of glioma, there are no clear and effective targeted drugs, and immunotherapy is also in the experimental stage. The status of maximum safe resection as the primary treatment for glioma has not yet been shaken, and resection of gliomas still needs to be based on the concept of eliminating the evil. Although some studies say that oligodendrogliomas can be removed without aggressive resection because of radiotherapy sensitivity; however, it is still more rewarding and bracing to cut more tumors with safety in mind, and the diagnosis of oligodendroglioma cannot be predicted with 100% accuracy preoperatively. In terms of probability, oligodendroglial cell tumors are only a minority of all gliomas. Therefore, the philosophy of glioma surgery has not changed in the era of molecular diagnosis and remains maximum safe resection.