Objective The purpose of our study was to summarize the clinical features and pathological composition of mixed germ cell tumors in pineal region,and to discuss the related therapeutic strategies.Methods We performed a retrospective analysis in 14 cases of mixed germ cell tumors in pineal region with open surgical resection and detailed pathology.Results All the 14 cases were male,and the average age was 17.3 years.The ingredient of germinoma existed in 13 cases,and the other ingredients were either simple mature teratoma,or multiple high - grade malignant germ cell tumors.The increased level of serum tumor markers on the whole suggested the existence of relevant ingredients in the tumor.Conclusion There is no significant specificity in the clinical manifestations of mixed germ cell tumors in pineal region.The ingredient of germinoma exists in most cases,so comprehensive and accurate preoperative qualitative diagnosis is difficult.It seems more reasonable to acquire complete pathologic diagnosis through surgical resection before a pertinent combined therapy.The “diagnostic” radiotherapy should be prudent in case of normal level of serum tumor markers and mixed tumor density or signal on image.