Malignant gliomas are the most common intracranial primary tumours. Despite aggressive treatment strategies as surgery, radiation and chemotherapy, the vast majority of patients die about one year after diagnosis. In this article we discuss histo-pathological and moleculargenetic structures of glioma. We evaluate specific topographical areas of the brain with respect to tumour surgery and radical tumour exstirpation. Gross total resection versus debulking are compared regarding the median survival time. The importance of radiotherapy and chemotherapy subsequent to surgery will be pointed out. We conclude that to date the treatment of choice in malignant gliomas of the brain is multimodal and includes surgery (the extent of surgery is limited by functionally important areas), radiotherapy and chemotherapy. However, since the median survival time averages still about one year, in the future new treatment strategies, for example gene therapy, have to be approached.