Objective To summarize the clinical features and treatment of pineal parenchymal tumors of intermediate differentiation (PPTIDs).Methods A retrospective analysis was performed on the clinical data of 6 patients with PPTIDs. Poppen approach was used in 3 cases, transcallosal interforniceal approach was used in 2 cases, and transtrigone lateral ventricle approach was used in 1 case. After operation, 4 patients received radiotherapy, and 2 patients received chemotherapy.Results All the tumors were surgically removed, including total resection in 1 case, subtotal resection in 4 cases, and partial resection in 1 case. After operation, 1 patient died during the perioperative period; among 5 patients followed up, 1 died, and 4 survived.Conclusions PPTIDs are rarely seen. The diagnosis of PPTIDs mainly depends on clinical manifestations, radiological findings, and histopathological features. The patients with PPTIDs should be treated by microsurgery combined with postoperative radiotherapy and chemotherapy.