The development of a multidisciplinary brain tumor center requires many steps, from selection of leaders to garnering institutional support, growing the clinical neuro-oncology business, and building multidisciplinary involvement especially with the tumor board. Key clinicians and researchers need to be recruited to develop the academic enterprise, and acquiring external endorsement and philanthropy support can be critical factors in maintaining institutional support and in meeting special needs of the center. The process of managing money, space and support personnel, and the maintenance of the overall program are important as well. Our views on building a brain tumor center reflect our specific situation in developing and growing the Hermelin Brain Tumor Center at Henry Ford Hospital in Detroit and hence might not be precisely applicable to the development of centers elsewhere.