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Purpose of Review: This article discusses common and emergent medical complications encountered in patients with primary brain tumors.Recent Findings: Clinical studies and systematic reviews published in recent years have improved knowledge regarding the incidence of neurologic and medical complications occurring in patients with primary brain tumors. Studies in tumor-related epilepsy and venous thromboembolism provide data for the clinician to make evidence-based decisions about perioperative management, prophylaxis, and therapy. Patients with brain tumors experience unique toxicities related to novel drugs and chemotherapeutics that result in hematologic, infectious, and endocrine disorders. Recent work that has focused on quality of life in patients with brain tumors highlights the importance of good supportive care and optimal medical management of neurobehavioral symptoms and late complications of treatment.Summary: A thorough understanding of the variety of medical and neurologic complications in patients with primary brain tumors improves the clinician’s ability to quickly recognize and manage common and urgent conditions.