We reviewed 35 patients with optic pathway gliomas treated at our department with radiotherapy (RT) alone (25 patients) or with postoperative RT (10 patients). Six patients in the RT alone group had optic nerve tumors and 19 had chiasmal tumors. In the subtotal surgery plus RT (STS-RT) group one patient had an optic nerve tumor and nine had chiasmal tumors. The RT alone group included 9 new cases with neurologic ± visual deficits, 12 new cases with significant visual deficits, 2 relapsed tumors, and 2 cases that had progressed during observation. The STS-RT group included 2 new cases with neurologic ± visual deficits, 5 new cases with significant visual deficits, 2 patients with relapsed tumors and one patient who had progressed during chemotherapy.The 10-year actuarial progression-free survival rate (10-y PFS) was 86% for patients with optic nerve gliomas and 41% for patients with chiasmal tumors. The 10-year actuarial survival rate (10-y S) was 75% for patients with optic nerve gliomas and 51% for patients with chiasmal gliomas.PFS and S rates were significantly lower in infants (10-y PFS: 19%; 10-y S: 33%), in patients with neurologic deficits (10-y PFS: 17%; 10-y S: 25%), in those with increased intracranial pressure (10-y PFS and 10-y S: 9%), and in patients with depression of consciousness (10-y PFS and 10-y S: 17%). Treatment modality did not influence the outcome but radiation doses ≤ 49 Gy were associated with significantly lower PFS and S rates.