This is both a historical proposition and one that has evolved with the times. 30 years ago, or even more than 20 years ago, there was only one answer: no therapeutic value = leave it to fate. The brain is the central system for all human activities and sensations. The brainstem is the center of the human brain that manages life, and is an important structure that connects the brain tissue to the spinal cord, and this structure from the brain to the spinal cord is called the midbrain, the cerebral bridge, and the medulla oblongata, respectively, according to its form and function. The vital tissues such as respiration and blood pressure, which manage our life activities, are also important, so when a lesion occurs in this area, it is often fatal. Twenty to thirty years ago, when people suffered brainstem injuries due to trauma, it was almost impossible for the patient to survive even a small amount of bleeding, and if the patient’s survival was not ensured through medical treatment, death was the only outcome. Nowadays, the situation is very different. With the rapid development of science and technology and the years of practice and efforts of neurosurgeons, this forbidden area has been broken, making surgery in this part of the brainstem a reality. Nevertheless, surgery in this area is still very difficult. When people are diagnosed with brainstem tumor through imaging, patients and their family members look very scared after being told, which is normal and understandable, but what is more confusing is the next step. Even if they find doctors who dare to do it and can do it in big hospitals, the result will not be good. So how do patients and families choose? In general, brainstem tumors must be treated in a specialized hospital of neurosurgery, because there must be specialists in neurosurgery, and there will be experienced and skilled senior doctors and experts, who will first make the diagnosis clear, because there is a difference between brainstem tumors and tumors surrounding the brainstem, and sometimes people may confuse this difference. Tumors in the foramen magnum area, four ventricles and cerebellum, which compress the brainstem, are relatively easier to operate and their danger level will be reduced. True brainstem tumors are tumors that occur inside the brainstem tissue, which are very difficult and risky to operate, but they are also completely operable, and if the operation is successful, probably the patient will save his life and be able to live well, such as hemangioma. In fact, the most difficult choice for patients and their families in life is glioma diagnosed as brainstem, because glioma is a malignant tumor, which is difficult to remove completely by surgery and will recur and grow quickly after recurrence, which presents us a difficult and greatly confusing problem. This depends on the age of the patient, the site of the tumor, the size of the tumor, and the economic situation of the family. I personally do not advocate surgery for brainstem glioma in elderly people over 70 years old, nor do I agree to operate on brainstem glioma patients from extremely poor families unless they strongly request to do so, but for young patients with good family financial situation, I still advocate surgery to give young people a chance to see the world for one more day. The patient will live a good life with chemotherapy and other treatments.