Overall, malignant primary and metastatic brain tumors remain as lethal in the 1990s as they were in the 1970s. Just as the introduction of radiation therapy 2 decades ago added several months to survival time, numerous chemotherapeutic trials have demonstrated only limited efficacy. Fortunately, recent discoveries in molecular medicine have not only revolutionized our understanding of the events that lead to tumorigenesis, but they have created novel tools for targeting malignant cells. Novel treatment modalities are now being tested in pre-phase I animal models, while others are in different stages of clinical trials. The purpose of this review is to briefly summarize the emerging strategies of gene therapy, antiangiogenesis, immunotherapy, and targeting tumor cells.