The western world is facing an aging population and this will present challenges for the medical profession insofar as most studies regarding therapy has been undertaken in a younger population. In this chapter we present our experience with intracranial tumor surgery in patients aged more than 70 years old. We find that in our selected aging patients undergoing surgery the results are comparable to the results in younger patients given that the same adjuvant therapy is given. Hence, we believe that the indication for surgery should be based on the physiological age rather than the chronological age of the patient. This and the potential sources of surgical morbidity must always be weighted against the natural history of the disease.