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Children and adolescents treated for central nervous system (CNS) tumors are at increased risk for developing chronic health conditions, some of which lead to functional limitations. As these individuals age, the ability to perform activities of daily living and engage in physical exercise is impacted.This article explores current literature surrounding barriers to exercise and ways to promote activity in survivors of pediatric brain tumors.A systematic search was performed using health-related databases and archival searching to identify available literature on physical activity in survivors of pediatric brain tumors between 2010 and 2017. Several seminal studies outside of the searched date range were also included.Despite benefits to exercise, few survivors of pediatric brain tumors engage in the recommended 60 minutes of physical activity per day for many reasons, primarily related to tumor location and treatment-related late effects. Nonetheless, intervention trials have demonstrated that aerobic exercise and resistance training are feasible and safe in survivors of pediatric brain tumors.Exercise can influence numerous domains of health, positively impacting quality of life, and should be encouraged in this population.