Brain tumors in elderly are increasing as the number of people, who comprise the older population, does. About half of the patients with brain tumors appear to be over 60 years of age. In this review article, Glioblastoma multiform, as the most common malignant tumor of the central nervous system (CNS) in elderly, is discussed in details of definition, prognosis, diagnosis, treatment and differential diagnosis. Other tumors such as meningioma, pituitary adenoma, the CNS lymphoma and metastasis are also included to be reviewed. Treatment plans, either conservative or aggressive, classic or novel, approved or under investigation, are presented. Furthermore different attitudes of treatment in the past and recently are also argued. Conventional therapy, surgery, radiotherapy, chemotherapy radioimmunotherapy, hormonal therapy and some other novel methods of treatments are discussed in details for the glioma. Determining factors which may be associated to the patient’s response to each treatment plan are also discussed. Finally, some age related issues are provided to be paid attention to consider an old patient with brain tumor, and planning an optimal treatment in order to make the best management decisions. Until recently, people with brain tumors in elderly, were used to be treated in conservative plans and often were excluded of the clinical trials but now the number of patients who desire and receive more aggressive therapy for brain tumors is increasing.