Medulloblastoma, first reported by Bailey and Cushing in 1925, is an intracranial malignancy that occurs in children and is one of the most malignant neuroepithelial tumors of the central nervous system. It is thought to occur as a result of the failure of the primitive myeloid epithelium to continue to differentiate. This tumor, which originates from embryonic remnant cells, can occur anywhere in the brain tissue, but the majority grows in the cerebellar earthworm above the roof of the fourth ventricle. The main manifestations of medulloblastoma are increased intracranial pressure, ataxia and other cerebellar symptoms, often diplopia and various cerebral neurological disorders. The treatment of medulloblastoma is mainly surgical resection and post-operative radiation therapy, which can be supplemented by chemotherapy in some cases. 1.Surgical resection: surgical resection is the main treatment method for this disease. A posterior median craniotomy should be performed, and the tumor should be completely or nearly completely resected as far as possible, so that the obstructed fourth ventricle can be restored. When resecting the tumor, separate the tumor along the arachnoid interface of the tumor surface as much as possible, and operate gently. When separating the lower pole of the tumor, it is often found that the bilateral posterior inferior cerebellar arteries are located posteriorly and laterally to the tumor. Because they often have branches supplying the brainstem, they should be strictly protected to avoid damage during surgery. Before dealing with the tumor supplying arteries, it should be excluded that the treated vessels are not the returning arteries of the posterior inferior cerebellar artery or superior cerebellar artery into the brainstem to avoid ischemia and functional failure of the brainstem after accidental injury. When dealing with the superior pole of the tumor, it is crucial to open the outlet of the middle cerebral aqueduct, but generally this step should be done after the tumor has been removed from other parts, so as to avoid the backflow of blood from the operation field blocking the aqueduct and the third ventricle. If the tumor is severely adhered to the brainstem, forced separation should be avoided to avoid damaging the brainstem and causing adverse consequences. If the tumor is largely resected and the conduit cannot be opened, extraventricular drainage should be left intraoperatively and ventriculoperitoneal shunt or intraoperative shunt should be done later to release supratentorial hydrocephalus. Some studies have reported that cerebrospinal fluid shunts are likely to cause spinal cord or systemic metastases in medulloblastoma patients, thus reducing the survival rate, but this is still controversial. Radiation therapy: Because of the rapid growth of medulloblastoma, high cell division index and location close to the ventricle and subarachnoid space, there are many conditions favorable to radiotherapy. The dose of radiotherapy depends on the patient’s age, and the dose should be sufficient. The whole brain radiation dose is 35-40 Gy above 4 years old, and the posterior cranial dose is 50-55 Gy. The dose is appropriately reduced between 2 and 4 years old, and no radiotherapy is temporarily given within 2 years old. Radiotherapy should generally be administered within 4 weeks after surgery. It has been proposed that there is no difference in survival rate between whole brain whole spinal cord low dose irradiation and high dose irradiation, and the key to radiotherapy for medulloblastoma is posterior cranial fossa high dose irradiation. Therefore, the current recommendation is 30-35 Gy for the whole brain, 50 Gy for the posterior cranial fossa, and 30 Gy for the spinal cord. attention should also be paid to the occurrence of long-term complications (such as developmental delay due to endocrine hypofunction in children) during radiotherapy. Chemotherapy: Medulloblastoma is effective in chemotherapy, but the efficacy is not long-lasting, especially chemotherapy with a single drug is generally ineffective, so currently most of the drugs are used in combination. With the gradual promotion of molecular biology testing, it is believed that individualized radiotherapy based on genetic testing can gradually become another major treatment modality for medulloblastoma.