There has been increase in the number of elderly patients undergoing brain tumor surgery due to advances in microsurgery and anesthesiology as well as to prevalence of brain tumor is increasing because both the number of elderly patients and age-adjusted incidence is increasing. The decision of whether to operate on brain tumors in elderly patients has not been made easier despite diagnostic and therapeutic advances facilitating their diagnosis. Variable factors should be considered in chemotherapy and radiation therapy of the elderly patient with brain tumor. In this paper the author presented the considering factors and suggesting proper management algorithm for brain tumors of elderly patients after reviewing related literatures. Two clinically experienced didactic cases were illustrated.