Medulloblastoma is the most malignant brain tumor in the skull. It occurs in children, mostly after the age of 12, and is rarely seen in adult patients. Most of the tumors grow in the cerebellar earthworms. The tumor grows rapidly, and tumor cells are often shed and metastasize along the cerebrospinal fluid. Due to the rapid progression of the tumor, most patients have a disease duration of less than 3 months. For children with unexplained headache, vomiting and unstable walking, the possibility of medulloblastoma should be thought of, and a cranial enhancement MRI can be done to make a clear diagnosis. The medical community at home and abroad agrees that surgery should be the first choice of treatment for medulloblastoma, and only on the basis of complete or subtotal resection of the tumor, postoperative radiotherapy and chemotherapy can achieve more satisfactory results. Complete resection can be achieved in the majority of patients through microscopic neurosurgery. Only in a few patients, where the tumor is severely adhered to the brainstem or aorta and forced separation would lead to life-threatening consequences, a small amount of tumor remains. Medulloblastoma is usually combined with obstructive hydrocephalus, and another purpose of surgery is to release the hydrocephalus. Director Zheng Xuesheng of the Department of Neurosurgery of Xinhua Hospital specializes in the technique of total resection of medulloblastoma, and pays special attention to avoiding the spread of tumor cells to the spinal canal or the third ventricle or lateral ventricle when dealing with the upper and lower borders of the tumor, and this technique is very important to reduce tumor metastasis and improve the prognosis of patients. Radiation therapy and, if necessary, chemotherapy must be administered after surgery for medulloblastoma. Patients are in the high-risk group if they are younger than 3 years old, or if they have tumor residual greater than 1.5 grams after surgery, or if they have disseminated metastases. If none of the above three conditions were met, they belonged to the average risk group. The postoperative radiotherapy regimens for patients in the two groups are different. Total CNS (whole brain, posterior cranial fossa, and spinal cord) radiotherapy plus posterior cranial fossa dosing is strongly recommended for patients in the high-risk group. Combined chemotherapy is also recommended for the high-risk group to improve their tumor-free survival rate. As for whether radiotherapy followed by chemotherapy after surgery, chemotherapy followed by radiotherapy, or simultaneous radiotherapy and chemotherapy, according to evidence-based medical research, these three procedures have no effect on prognosis and can be operated flexibly according to the patient’s specific situation. For medulloblastoma, total CNS radiotherapy is a mandatory treatment option, however, total CNS radiotherapy leads to significant growth retardation and endocrine disorders. Patients in the general risk group: again, total CNS radiotherapy + posterior cranial fossa dosing is required. To reduce the toxicity of radiotherapy, the dose of total CNS radiotherapy was adjusted to 23.4 Gy and posterior cranial fossa dosing to 55.8 Gy in combination with chemotherapy, which also achieved similar (slightly lower) efficacy of high-dose radiotherapy, but with significantly lower toxicity. However, high-dose whole CNS radiotherapy is still recommended for older patients whose growth and development have largely ended to minimize recurrence and metastasis. With regular and reasonable comprehensive treatment of medulloblastoma, the 5-year survival rate can reach about 80%, and there are also patients with long-term survival.