Purpose: As survival rates have improved owing to advances in management strategies for pediatric brain cancer, long-term complications such as endocrine dysfunction, have emerged as a major issue. This study investigated the long-term endocrine effects of childhood-onset brain tumors in a large number of patients Methods: This study included 151 patients with brain tumors diagnosed between January 1995 and December 2016. The following data were retrospectively reviewed: tumor location, tumor histology, endocrine abnormalities, hypothalamic involvement on brain imaging, treatment modalities, and trends in body mass index. Patients with brain tumors were categorized according to tumor location: sellar/suprasellar (SE/SUP-SE) and supra/infratentorial (ST/IT). Results: The mean age at diagnosis of patients with SE/SUP-SE tumors and ST/IT tumors was 9.9 ± 4.5 and 6.5 ± 4.2 years, respectively. The most common histologic type among patients with SE/SUP-SE and ST/IT tumors was craniopharyngioma (49.6%, 57/115) and medulloblastoma (66.7%, 24/36), respectively. Height SDSs for patients with SE/SUP-SE tumors were lower than those observed in patients with ST/IT tumors at diagnosis (-0.6 ± 1.4 vs. 0.1 ± 1.1, P = 0.017); however, the height SDSs were lower in patients with ST/IT tumors at the final visit (-0.3 ± 1.4 vs. -1.6 ± 1.8; P 0.001). Decline in height SDS in patients with ST/IT tumors was affected by young age at diagnosis ( P = 0.020). The prevalence of combined pituitary hormone deficiencies was higher among patients with SE/SUP-SE tumors than in those with ST/IT tumors (81.7% vs. 36.1%, P 0.001). The mean BMI SDSs in 98 non-obese patients with SE/SUP-SE tumors showed highest rate of increase during the first year after diagnosis (mean BMI SDSs difference: 0.6 ± 1.1, P 0.001). Among 98 non-obese patients at diagnosis, 36 patients (36.7%) developed obesity, which was significantly influenced by hypothalamic involvement (odds ratio, 3.1; 95% confidence interval 1.1-9.4, P = 0.043). Conclusions: The prevalence of combined pituitary hormone deficiencies and obesity was higher in patients with SE/SUP-SE tumors than in those with tumors in other locations; growth impairment was more severe in patients with ST/IT tumors.