1000 children aged 0–14 in Australia/New Zealand are diagnosed with cancer annually, with paediatric brain cancers causing 40% of cancer-related deaths despite representing only 14% of diagnoses. Although overall cure rates exceed 80%, many brain tumour types have bleak outlooks, and survivors often face lifelong clinical sequelae. The Australian Brain Cancer Mission (ABCM) and the Australian and New Zealand Children's Haematology/Oncology Group (ANZCHOG) have addressed challenges in clinical trial execution, leading to the initiation or expansion of 11 clinical trials. These trials aim to improve survival rates and quality of life for children with aggressive brain cancers, leveraging international collaborations and innovative treatments. Despite progress, challenges remain in funding and resource constraints, necessitating sustained strategic funding and international partnerships to advance paediatric brain cancer research.