Low-grade glioma, uncommon. Usually dormant and, in most patients, eventually evolve into fatal tumors. Surgery, radiation, and chemotherapy are certainly effective in selected patients. Much uncertainty still exists about the most appropriate treatment options for these patients. 1. For large tumors, or for patients with extensive neurologic symptoms, immediate surgery is universally indicated. The goal is to obtain a diagnosis and reduce tumor size. 2, In patients with transient symptoms, as well as tumors that are small and do not cause occupying manifestations, we recommend surgical resection. However, careful follow-up is also an option for such patients. If there is evidence of accelerated tumor growth or progression to high-grade glioma, surgical resection is indicated. 3. For patients who opt for resection, we recommend maximal removal of the tumor rather than simple reduction in size. 4. Surgery alone is not a complete cure for this low-grade tumor, and additional treatments, such as radiation and chemotherapy, are ultimately necessary for all patients. The most appropriate timing of additional treatments is currently inconclusive. Those factors that necessitate the administration of additional therapy immediately after surgery are the presence of tumor-related symptoms, or risk factors suggesting a poor prognosis. These include age greater than 40 years, preoperative tumor greater than 5 cm, incomplete resection, astrocytoma component, rising MIB-1 (murine monoclonal antibody to Ki-67 nuclear antigen) index, combined deletion of 1p19q, and deletion of the IDH (isocitrate dehydrogenase) mutation. Importantly, individual risk factors are relative and biological continuity is always present. (1) For patients ≤40 years of age, with total tumor resection and no risk factors on molecular biology, we recommend that postoperative follow-up be given. (2) For older patients with residual postoperative disease and one or more unfavorable molecular biological features, we recommend that additional therapy be given immediately after surgery. (3) In general, the more risk factors a patient has, the greater the likelihood that we will recommend immediate administration of immediate therapy. (4) For patients with high-risk factors, and low-grade gliomas, we recommend that radiotherapy + chemotherapy be given postoperatively, rather than just one method. For chemotherapy, we recommend the PCV (methylbenzylhydrazine, lomustine, vincristine) regimen rather than temozolomide. the PCV regimen has been shown in randomized clinical studies to improve survival, and temozolomide is effective, easy to administer, and well tolerated, but evidence is lacking in this tumor type. 5. Surgery, radiotherapy and chemotherapy are all useful in patients with postoperative recurrence. The location of the patient’s tumor, the degree of recurrence, and the history of previous treatment can all play a role. The location of the tumor, the degree of recurrence, and the history of prior therapy can determine the administration of additional subsequent therapy. 6. Hairy cell astrocytoma has a favorable prognosis. Surgery is aimed at obtaining a diagnosis, and as the initial treatment, total excision can be curative. Radiation therapy should be used for unresectable or when the lesion is progressive.