The brain stem consists of midbrain, pons and medulla. Brain stem gliomas are divided into diffuse focal, exophytic and cervicomedullary. Brain stem gliomas are predominantly a disease of childhood. Patients present with ataxia, weakness, cranial nerve palsies and/or manifestations of increased tension. MRI is the imaging modality of choice but it is not available worldwide as the CT. Treatment options include surgery, irradiation and chemotherapy.