A recent increase in diagnoses of pediatric neuro-oncology tumors combined with recent advancements in medical treatment of such tumors has resulted in a growing cohort of pediatric brain tumor survivors. These survivors are at risk for short and long-term psychological adjustment problems. Most studies regarding these survivors have focused on children who have received combinations of surgery, radiation, and chemotherapy as medical treatment. The sub-group of pediatric neuro-oncology patients who receive surgery as the only form of medical treatment has not been closely followed for adjustment problems. In this study, data were retrospectively collected from semi-structured clinical interviews with 34 ‘surgery-only’ pediatric neuro-oncology patients who were 2 weeks to 5 years off medical treatment for their tumor. These data suggest that these survivors may be experiencing significant short and long-term mood, behavioral, and academic adjustment problems in comparison to national averages for children regarding these issues. Additional research examining the psychological adjustment process for surgery-only pediatric neuro-oncology patients is needed to validate these preliminary findings and facilitate the development of targeted interventions to address the identified adjustment problems. Copyright © 2002 John Wiley & Sons, Ltd.