AIM: To study the clinical features, imaging findings, treatment methods and results, and prognosis of supratentorial parenchymal ependymomas in children. MATERIAL and METHODS: Fourteen children with supratentorial parenchymal ependymomas were treated by the senior author at Tiantan Hospital between October 2004 and May 2010. The clinical manifestations, neuroimaging findings, treatment methods, and therapeutic results were retrospectively reviewed. RESULTS: The study included 11 boys and three girls. The patients were aged from 1 to 14 years with an average age of 6.1 years. Gross total surgical removal (GTR) was achieved in 10 cases, and subtotal removal (STR) was achieved in four cases. There were six ependymomas, seven anaplastic ependymomas, and one subependymoma. The mean follow-up duration was 78.9 months (range, 4-122 months). During the follow-up period, 10 patients who underwent GTR (71.4%; only 1 patient had a recurrent tumor during this time) had an excellent postoperative outcome (Karnofsky Performance Status 80), while four patients who underwent STR (28.6%) developed recurrent tumors and died. CONCLUSION: The preoperative diagnosis of supratentorial parenchymal ependymomas is difficult. GTR can be achieved with a favorable long-term outcome using an improved microsurgical technique.