Objective: We describe an unusual presentation of a congenital gemistocytic astrocytoma Grade 2 presenting antenatally on 36 week scan. Methods: Case report Results: Baby was born in good condition at term via emergency Caesarean section for suboptimal cardiotocograph. Antenatal scan at 36 weeks for polyhydramnios showed an incidental cyst in the right parietal region measuring 2.65 cm × 1.67 cm. Newborn examination was normal but the head circumference (91st centile) was disproportionate to weight (50th centile). Postnatal cranial ultrasound scan and MRI head confirmed presence of three cysts in the right temporal lobe with mass effect in right middle cranial fossa and right parietal lobe but without midline shift. The largest cyst measured 3.2 × 3.8 x 4.7 cm with a lobulated 1.4 x 1 cm soft tissue mass within. There was a feeding vessel to the contrast-enhancing mass, which contained flow void and haemosiderin deposition with popcorn configuration. Initially, the head circumference was stable but subsequent surveillance MRI scan showed an increase in lesion size. The lesion was completely resected at 1 month old with histology confirming gemistocytic astrocytoma Grade 2. He did not require chemotherapy or radiotherapy and was discharged home with regular follow up. At 18 months, Baby's development was normal with no relapses on serial MRIs. Conclusion: Congenital brain tumours are very rare, even more so when presenting antenatally. Usually associated with poorer prognosis relative to comparable WHO grade brain tumours, gemistocytic astrocytoma usually affects older children and is a histologic subtype of low grade astrocytoma with no specific imaging features. 1,2 A challenging diagnosis, early multidisciplinary team involvement is crucial in ensuring timely diagnosis and treatment.