Following the introduction of CS-RT the survival rate for this malignant tumour rose from zero to approximately 50%. It appears that the major advances over the last twenty years associated with the introduction of CT/MRI, adequate staging, total resection, adjuvant therapy and improved radiation technique has only added 10-20% to the survival rate making it extremely difficult to evaluate the impact of these advances. While radiation treatment is currently omitted or delayed under the age of 36 months, due to enhanced neurocognitive toxicity, and replaced by maintained systemic therapy, the early encouraging results must stand the test of time in order to become standard practice. The treatment of a child with medulloblastoma with radiation treatment remains the corner stone of treatment while additional novel therapies are being developed.