Gliomas of the optic pathways and hypothalamus are among the most common suprasellar neoplasms in children second to craniopharyngioma. Optic gliomas are the most common intracranial neoplasm in neurofibromatosis type I (NF1). However over half of children and adults with optic gliomas will not have NF1. Optic gliomas may occur at any point along the visual pathways. Hypothalamic astrocytomas are generally similar histologically but are less likely to be associated with NF1.