Ependymomas are one of the more common childhood brain tumors. After total resection, outcome is excellent. However, for patients whose tumors are subtotally resected or anaplastic, disease relapse is common. Dr. Roger J. Packer of Children’s National Medical Center summarizes the outcomes of new treatment approaches, the possible value of adjuvant chemotherapy, and new biological insights into the tumor. The increased biological understandings have important management connotations.