Patients with grade II gliomas are not curable. Grade II gliomas are mainly seen in adults and are predominantly astrocytomas. The biological behavior shows a malignant process, but the clinical outcome is better than that of grade IV gliomas, and their 10-year survival rate can approach 30-40%. Generally, the prognosis of patients with grade II glioma is mainly based on pathological diagnosis and molecular detectors after surgery. Some grade II gliomas are close in malignancy to grade IV gliomas, and the pathological findings of patients are manifested in the presence or absence of MGMT methylation, IDH1 and IDH2 mutations, such as MGMT negative, IDH1 and IDH2 unmutated wild type, such grade II tumors have the same clinical outcome as grade IV glioblastoma multiforme patients and have a poor prognosis. Treatment of these tumors requires high priority and comprehensive postoperative care. The majority of patients with grade II gliomas are treated with surgery, radiation and chemotherapy, and enter the observation period as prescribed. If no mutation is present, they need to be treated as grade IV gliomas, with regular treatment and review.