Medulloblastoma is a type of brain tumor that commonly affects children, and it includes different subtypes that have varying characteristics and outcomes. Even with current treatments, long-term survival rates are low, and survivors often face various health challenges. However, this article discusses new treatment strategies that combine molecular and clinical factors may help to better identify patients at risk and improve outcomes. There is also ongoing research to better understand the tumor's complexity, and new clinical trials are exploring different approaches, such as precision medicine and immune therapy, for treating relapsed tumors. The Pacific Pediatric Neuro-Oncology Medulloblastoma Working Group is dedicated to supporting research efforts and developing new clinical trials based on these findings.