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Cerebellar mutism has been a well-known clinical entity that develops in a subset of patients who have undergone resection of posterior fossa tumors. It is characterized by severely diminished or absent speech output as well as other neurological, cognitive, and behavioral impairments. Though increasing numbers of case reports and literature reviews that indicate the cerebellar mutism, the mechanism of occurrence and best therapeutic approaches are not established. This article reviews current status of this devastating complication with respect to epidemiology, anatomical substrate, pathophysiology, risk factors, treatment options, prognosis and prevention.