Pilocytic astrocytoma （PA） is the most common low-grade brain tumor in children and is commonly observed in the optic nerve， optic chiasma， hypothalamus， brain stem， cerebellum， and cerebrum. PA often has clear boundaries and slow growth and belongs to WHO I tumors， and surgical resection is the preferred regimen for treatment. However， due to the importance of nerve functions of the optic nerves， optic chiasma， hypothalamus， and brain stem， total resection may not be possible. At present， no conclusion has been reached on the postoperative treatment of pediatric PA， and the main postoperative treatment methods for pediatric PA include radiotherapy， chemotherapy， targeted therapy， and follow-up observation. With the advances in imaging and radiation techniques， in addition to traditional fractionated radiotherapy， the treatment methods also include conformal radiotherapy， stereotactic radiotherapy， and proton therapy， aiming to reduce the toxic and side effects of radiotherapy and improve the efficacy of radiotherapy， but most scholars currently do not recommend radiotherapy as the first-line treatment for pediatric PA after surgery. The chemoradiotherapy regimen of vincristine combined with carboplatin is the preferred regimen for progressive PA， and the combination of irinotecan and bevacizumab can be used as the second-line therapy. There has been a rapid growth in the development of target therapy， and targeted drugs represented by mitogen-activated protein kinase inhibitors are expected to become the first-line drugs for the postoperative treatment of pediatric PA due to a fewer toxic and side effects and a better clinical effect， but there is still a lack of high-level clinical evidence. Follow-up observation is one of the options for children with PA after surgery， and some scholars have proposed hierarchical treatment regimens for children with PA and recommended postoperative follow-up observation for low-risk patients. This article reviews the advances in the postoperative comprehensive treatment of pediatric PA.