Background: Brain and central nervous system (CNS) cancer ranks as the second leading cause of death among all cancer-related fatalities globally in individuals under 20 years old. Despite its significance, there is a notable dearth of data on brain and CNS cancer in this age group, necessitating a comprehensive cross-country comparison. Methods: Utilizing the Global Burden of Disease study framework, we estimated the prevalence, incidence, deaths, and disability-adjusted life years (DALYs) attributable to brain and CNS cancer by age, sex, year, and location across 204 countries and territories from 1990-2019. Results: The total prevalence increased from 153,334 (95%UI: 111,452-233,819) in 1990 to 212,459 (164,908-245,556) in 2019, with incidence rising from 47,373 (32,635-74,710) in 1990 to 47,600 (36,572-55,194) in 2019. Notably, the annual percentage change (APC) in deaths decreased by 21% (56-15), and DALYs by 22% (57-15) from 1990-2019. Sub-Saharan Africa and the African Union exhibited the highest APC increase in deaths, while Southeast Asia, East Asia, and Oceania experienced the most significant decrease. The highest APC in incidence occurred in the 10-14 years age group at 27%, with a slight increase of 1% in deaths observed in the 10-19 years age group. Females bore a higher burden compared to males, with APC in prevalence at 29% versus 51%, and incidence at -4% versus 7%. Conclusions: Brain and CNS cancer accounted for 9.55% of deaths among individuals under 20 globally in 2019. While the overall global trend has shown an increase over the last three decades, females exhibit a higher burden. Despite a decrease in deaths over the same period, strategies must be implemented to combat this burden, emphasizing the importance of early investigation and management, particularly in resource-limited settings worldwide.

APC: Annual percentage of change, DALYs: disability adjusted life years.