Surgery remains the cornerstone of Glioma treatment & aids in identification of molecular underpinnings of Glioma. Novel radiation schedules like fractionation are being studied with Immunotherapy. For 20 years we have not seen meaningful progress with either Chemotherapy or Immunotherapy hence Glioma treatment still relies on chemotherapy with alkylating agents. We need strategies to identify patients with druggable mutations like BRAF & NTRK to enable access though participation in clinical trials. With the failure of 3 Phase-3 clinical trials Immune Check point inhibitors are largely unsuccessful and novel immunotherapy combinations with other check point inhibitors or Oncolytic viruses need to be explored. GBM being cold tumor with low activated T cells remains challenge for Immunotherapy.