We report here the clinico-pathological data about 4 patients with brainstem tumors. Clinical symptoms were variable but allowed a correct topical diagnosis. On the other hand, all the neuroradiological examinations, especially CT scan of the brain, resulted always negative or without diagnostic value. Good results for the diagnosis were given by pneumoencephalography and ventriculography. The neuropathological examination revealed one spongioblastoma, two malignant astrocytomas and one pontine metastasis of carcinoma of esophagus. Diagnostic troubles, even with modern and sophisticated techniques are stressed here. The clinician should not overweight negative results obtained with these techniques and every time include in the differential diagnosis brainstem tumors.