Every year in Germany, around 380 children younger than 16 years of age are diagnosed with a brain tumor. Compared with adults, different types of brain tumors are found in children. The diagnosis is often delayed despite presentation with characteristic symptoms. Nonspecific persistent symptoms must be followed with further diagnostics. Since the 1980s, multimodal therapeutic regimens have been developed systematically by the Society for Pediatric Oncology and Hematology (GPOH) in the context of treatment optimization trials. Neurosurgery, chemotherapy, and irradiation are applied according to the histology, stage of metastasis, and age of the child. Currently, 80–90% of the children diagnosed with brain tumors in Germany are treated according to the respective trial in the context of the treatment network HIT. The principle aims are improved survival and quality of life, reduction of therapy-associated toxicity and late effects, and better diagnostic and therapeutic standards. In this article, typical clinical symptoms and diagnostic recommendations are described, and the structure of the HIT treatment network is illustrated.