The present study was designed to describe theories of illness and coping with the disease in brain tumor patients. It addresses the following questions: 1. To what attribute brain tumor patients their illness? 2. How do they cope? 3. Are causal attributions and coping modes related to emotional states, such as distress, hope, and depression? N = 33 newly diagnosed patients suffering from benign or malignant intracranial tumors are included in the sample and interviewed presurgically. Assessment methods combine both qualitative and quantitative instruments. Among the causes discussed in the interviews are incidents that can be classified as mechanical traumata. They have the highest frequency. In patients' self-reports, distress is rated low, hope high. Interviewers rate distress higher and hope lower. Among the modes of coping, compliance, fighting spirit (as assessed in a questionnaire), distraction, social support, optimism, and acceptance of the disease (as assessed by interview and content analysis) are the most frequent. The results are discussed under methodological and illness-related perspectives.