The diagnosis of intracranial tumors in children is often more difficult than that of adults, and the misdiagnosis rate of brain tumors in children was once higher in the early stage due to the lack of effective examination means. With the gradual increase of knowledge about pediatric brain tumors and the popularization of CT, MRI and other examination means, the chance of being misdiagnosed has been greatly reduced now, but we can still see misdiagnosed cases in the clinic. Therefore, it is important to pay attention to it. The misdiagnosis of intracranial tumor in children is considered to be related to the following factors: 1. young children cannot express their symptoms correctly, and often rely on family members’ recollection and speculation to describe them, which increases the difficulty of doctors’ judgment; 2. children cannot cooperate well in the neurological examination, and young children often cry so that positive signs are not easily detected by surgeons; 3. cranial suture or fontanelle is not closed, and brain tumor makes The symptoms of intracranial tumors in children are sometimes atypical and often confused with other diseases, especially those that occur after head trauma or other diseases, which are often misdiagnosed as diseases unrelated to brain tumors. Among the common pediatric brain tumors misdiagnosed in our clinical practice, according to the frequency of misdiagnosed diseases, they are encephalitis or meningitis, epilepsy, gastrointestinal disease, central urinary tumor, and congenital hydrocephalus, in order of frequency. Avoiding misdiagnosis is the first step in giving our children the right treatment, and parents would be wise to seek confirmation of the diagnosis from a professional neurosurgeon when they encounter these diagnoses. Misdiagnosis of meningitis: Children with headache, fever, and neck resistance (also known as cervical ankylosis) are often treated as meningitis without lumbar puncture. This kind of neck resistance is the result of chronic subungual herniation of the cerebellum, which is dangerous when lumbar puncture is performed and can induce brain herniation in children; 2. Misdiagnosis as epilepsy: If a child develops epilepsy, the real cause of the seizure must be found and antiepileptic treatment must not be carried out blindly, as long as the child has a CT examination to clarify. There is a special category of children with “demented laughter epilepsy”, so we should pay attention to whether there is a hypothalamic malformation tumor, and MRI examination will show it more clearly; 3. “The first symptom of suprasellar germ cell tumor is polydipsia and polyuria, such children must be examined by CT and MRI, especially MRI, to understand whether there is a mass in hypothalamus. 5. Misdiagnosis of congenital hydrocephalus: Children with congenital hydrocephalus are born with a large head circumference, and after birth the head circumference increases rapidly, the scalp is prone to varicose veins, the fontanelle is huge and the tension is high, but there is no headache and vomiting. In contrast, children with hydrocephalus are generally born with normal head size, and from a few months to 2 years of age, parents will notice a rapid increase in head circumference, often accompanied by headaches and vomiting.