We will review the incidence, prevalence, treatment, and outcomes of adult gliomas. This will include a review and update of primary management for low and high grade gliomas, including the incorporation of targeted therapies in upfront management. This will also include a description of treatment options for recurrent disease, again including targeted therapies and reirradiation treatment strategies. At the conclusion of this activity, the learner will be able to do the following: 1. Discuss the incidence, prevalence, mortality, morbidity, and clinical impact of the major malignant adult primary CNS tumors. 2. Recognize the substantial heterogeneity that exists within these tumor types and explain the prognostic and predictive variables allowing for appropriate selection of therapeutic choices, tailored for a specific patient. Explain the major levels of evidence for therapeutic decision-making. 3. Describe the role of various therapies, especially surgery, radiotherapy, and chemotherapy in managing these tumors. This will focus particularly on the emerging role of targeted therapies and re-irradiation in the management of these tumors.