Gross total resection (GTR) is curative for cerebellar astrocytoma (CA), a rare type of central nervous system tumor. Twenty patients were diagnosed with cerebellar pilocytic astrocytoma; 9 (45%) had GTR; and there was no recurrence of the tumor during the median follow-up of 6 months. The aim of the study was to take stock of how different surgeons tackled removing astrocytomas from the posterior fossa of the brains of both young and old patients who had received timely diagnoses. During the period 2021 and 2023, researchers at Al-Azhar University conducted a prospective study on twenty individuals. Individuals of either sex and any age who have a lesion in the posterior fossa of the brain and suspect it is an astrocytoma are eligible; cases that have already been treated with radiotherapy or chemotherapy are excluded. The mean age was 14.43(3 – 37), 8 (40%) males and 12 (60%) were females. Twelve of the participants had a cystic tumor, while eight had a mixed tumor. Nine individuals had lesions in the left cerebellar hemisphere, six in the right, and five in the vermian. The greatest diameter of the tumor was among 3.0 and 6.67 cm. In 11 patients, gross-tumor-resection (GTR) was accomplished, and in 9 patients, STR was performed. Thirteen people had to have a V-P shunt put in permanently. Both the pre- and post-operative visual symptoms differed significantly from one another, and the pre- and post-operative headache symptoms differed highly statistically. Surgical approach to posterior fossa astrocytoma still represents a challenge for neurosurgeons. If successful, GTR is a cure for cerebellar pilocytic astrocytoma. If the individual requires pre-operative insertion of a V-P shunt to reduce intracranial pressure (ICP) in conjunction with GTR of the tumor, the outcome is excellent. Good and excellent surgical outcomes for patients with astrocytomas of the posterior fossa of the brain can be achieved through early diagnosis, the development of microsurgical techniques, and the careful selection of the most appropriate surgical approach.