Tumors of the pineal region account for 0.5% to 1% of the human brain tumors. Melatonin is essential in regulating circadian rhythms. The clinical presentation of the pineal region tumors includes hydrocephalus, Parinaud's syndrome, thalamic affection, and dementia. Investigations include measures of the tumor markers in both blood and CSF and CT and MRI. Control the hydrocephalus either by shunt or ETV with the benefit of endoscopic biopsy. Total resection of benign tumors of the pineal region.