Advances in understanding neural stem cell (NSC) biology have facilitated the development of novel cell-based therapies for brain malignancies. NSCs are the most immature progenitor cells in the nervous system that have the ability to self-renew, differentiate into terminal neural cell types, and extensively migrate to areas of pathology in the central nervous system. Because of their inherent tumor-trophic properties and their capacity to differentiate into all neural phenotypes, NSCs represent a powerful tool for the treatment of both diffuse and localized neurological disorders. Progress has validated the feasibility of using engineered NSCs as cell-based therapeutic agents to eliminate malignant cells in the brain. This review discusses the therapeutic potential of NSCs focusing on brain tumors.