Objectives: To study the clinical characteristics and Stereotactic neurosurgery role in determining pathology of pineal region tumors. Methods: To combined retrospective and prospective studies of 58 patients at Cho ray Hospital from 01/3002 to 04/2012. Results: The male-female ratio is 5/1. The mean age of patient is 19 years, minimum age is 4 and largest age is 60. Clinical symptoms are headaches 100 percent, vomiting 63.8 percent, blurred vision 63,8 percent, double vision 6.9 percent, epilepsy 8.6 percent, Parinaud 24.1 percent, papilledema 17,2 percent, dizziness 8.6 percent, weakness on left side of body 8,6 percent, 1.6 percent tinnitus, sixth nerve palsy 12.1 percent. The rate of positive Stereotactic neurosurgery is 25/ 27 and the death rate is 0/ 27. Conclusions: Stereotactic neurosurgery is a minimally invasive surgery which plays an important role in determining pathology, reduces mortality and side-effect in the treatment of pineal region tumors.