The aim of present study was to determine the relative frequency of primary brain tumors among childrenunder 14 years of age in Pakistan. A retrospective review of pediatric primary brain tumors, encounteredover 13 years (January 1998 through July 2010) at the Neurosurgical Unit of the Pakistan Institute of MedicalSciences (PIMS), Islamabad, Pakistan, was made covering 231 cases, 142 (61.5%) males and 89 (38.5%) females,with a male to female ratio of 1.69:1. The cases were divided into 5 age groups each covering three years of life(0-2, 3-5, 6-8,9-11 and 12-14 years), with the greatest number in age group 3 i.e. 6-8 years (32%) and the leastnumber of patients in age groups 1 and 5 (10.3% each). The 231 malignancies were categorized by site into twogroups, supratentorial (83 cases; 35.9%) and infratentorial (148 cases; 64.1%). The morphological distributionwas medulloblastoma (33.3%), astrocytoma (24.7%), mixed gliomas (14.7%), craniopharyngioma (11.7%),ependymoma (8.7%), PNET (6.1%) and pineal tumor (0.9%). Since only a single institution was studied, cautiousinterpretation is needed. Ideally, a population-based approach would be adopted to determine the cancerburden due to pediatric malignancies of the brain in this population and for their morphological categorizationin Pakistan.