Hypothalamic obesity is a condition with extremely high morbidity. Mechanisms leading to the profoundly disturbed energy homeostasis are complex. Craniopharyngioma is one of the most common pathogenesis of hypothalamic obesity, which leads to the damage of hypothalamic nucleis due to the tumor compression or/and cytokines stimulation. The purpose of the present chapter is to summarize data on the prevalence of hypothalamic obesity, discuss the clinical features and review the diagnosis and treatment of these patients. Differences tumor growth patterns and locations should be considered when comparing outcomes and survival across different treatment paradigms in patients with CP. Further studies should be conducted to better understand the mechanisms of rapid weight gain and metabolic syndrome in patients with CP and could be used to enhance effective treatments and establish prevention strategy.