Rosette-forming glioneural tumors (RGNT) of the fourth ventricle are rare biphasic tumors comprising both glial and neurocytic elements. It is described as a disease, which mainly affects young adults in the World Health Organisation central nervous system tumor classification. To our knowledge, our patient is the oldest reported patient with RGNT in literature. In this case report, we present an atypical diagnostic age and an infrequent complication related to surgery for this age group. An 81-year-old female presented after an episode of sudden collapse on a 2-month background history of headaches and gait disturbance. On examination, the patient had mild gait ataxia but no focal neurological deficits. Computed tomography of the brain revealed a mixed attenuation intra-axial lesion centered on the cerebellar vermis with associated foci of calcification causing obstructive hydrocephalus. The patient underwent a posterior fossa craniotomy and excision of the lesion through a transvermian approach. The patient was well in the initial postoperative period with no deficits but 1 week later developed cerebellar mutism. RGNT is a rare entity only previously been reported in young adults. Age of diagnosis was noted to be a distinguishing feature of this condition. Our case highlights that the clinicopatholgic characterization of RGNT should be revisited, as these lesions can occur over a broad age group. From a limited number of cases studied to date, RGNT seems to be slow growing and relatively indolent tumor. Copyright © 2013 by Lippincott Williams & Wilkins.