Objective To review the leading roles of glioma stem cells (GSCs) and their sophisticated interactions with other cells in the tissue remodeling process of gliomagenesis.Data sources Published articles about assessing GSCs in tumor initiation,progression,and multiple interactions with other cells in the special microenvironment were selected using PubMed.The search terms were "glioma stem cells","tumorigenesis",and "microenvironment".Study selection Articles regarding the tissue remodeling of GSCs in gliomagenesis were selected.Results GSCs exhibit enhanced tumor-initiating ability,could reestablish tumor,and were resistant to radiotherapy and chemotherapy.Studying the role of GSCs in gliomagenesis helps to develop targeting therapy against GSCs,which seems to be a cure for gliomas.However,sophisticated interactions between GSCs and their local microenvironment during tumor remodeling,including integrating with partially differentiated tumor cells,GSCs niche,neural stem cells (NSCs),normal glia,tumor-infiltrating lymphocytes,may obscure the leading role of GSCs during gliomagenesis,and make single targeting therapy unsuccessful.Conclusions Understanding the biological behavious of GSCs and their regulatory mechanisms may directly impact current efforts for more directed therapeutics against the highly aggressive gliomas.For multiple possible sources to turning into GSCs,simply eradicating the existing GSCs is not enough to be a cure for gliomas,blocking the potentialsources of GSCs and ameliorating the local tumor inducing/promoting microenvironment should be a reasonable strategy.