Objectives To review the cognitive changes associated with infiltrative, malignant brain tumors and treatments for brain tumors. Data Source Review of journal articles and textbooks. Conclusion Improvements in surgical, radiation, and medical therapies for central nervous system malignancies have resulted in increased patient survival. However, an increase in cognitive decline also has been associated with the presence of tumor and with tumor treatment modalities. Consequently, a negative impact on quality of life, as well as additional stress on caregivers occurs. Implications for Nursing Practice The role of the neuro-oncology nurse is to assist in identifying cognitive impairments in patients with central nervous system malignancies, and to aid in promoting strategies for improved quality of life for patients and their caregivers. The long-term goal for the neuro-oncology community is to further improve treatments, to minimize side effects and, ultimately, to reduce the cognitive sequelae of these tumors and their treatments.