The treatment of intracranial germ cell tumors has made a lot of progress in the last decade, with the most important emphasis on comprehensive treatment and group treatment according to pathological type. We suggest that first, regardless of the location of germ cell tumors, conditions should be created for surgery to clarify the pathology as the first choice. Because there are many types of germ cell tumors, different types have different degrees of malignancy and similar imaging, but the prognosis is completely different, if misdiagnosed in pathology, it will bring great disaster to the treatment. Second, for different types of germ cell tumors, germ cell tumors should be treated with chemotherapy combined with radiotherapy as the best therapy. Surgical radical treatment of mature teratoma is the main treatment, small tumors can be eradicated at one time, and large tumors can be excised in stages to increase the success rate of surgery and the chance of radical treatment. In the group with medium prognosis, for those with immature teratoma, if there is no tumor residue after surgery, radiotherapy is not necessary, and CT and MRI should be followed up closely to grasp the changes of the disease; if there is tumor residue after surgery or recurrence occurs in the follow-up stage of patients with total excision, further gamma knife treatment can be performed with definite efficacy. For those with embryonal carcinoma component, it is not necessary to pursue total resection during surgery, perfect radiotherapy after surgery, and gamma knife treatment can also be attempted. In the group with poor prognosis, neoadjuvant treatment is feasible, and comprehensive treatment measures such as pursuing total excision in surgery and perfecting continued radiotherapy after surgery can improve the survival rate. Looking into the future, the author believes that there are several issues worth exploring. First, the effect of postoperative gamma knife treatment of immature teratoma needs to be further clarified in a large sample follow-up. Second, the effect of neoadjuvant therapy needs to be clarified by further prospective studies. Third, high-dose chemotherapy + autologous hematopoietic stem cell transplantation is effective for the treatment of non-solid tumors, but how effective it is for solid tumors such as intracranial germ cell tumors needs further attention.