Abstract: Objective To evaluate the short-term clinical outcomes of intracranial germinoma patients treated with craniospinal irradiation (CSI) using helical tomotherapy (HT) system. Methods Twenty-three patients who were treated with CSI in our center from January 2008 to July 2012 were collected, with an average age of 20 years old. The total doses were 27-36 Gy/15-20 F (1.5-2 Gy per fraction), and the total local doses were 46-60 Gy/30-50 F (5 fractions per week). All female patients for CSI were treated with left-right parallel-opposed field irradiation to protect their ovarian functions. The SPSS19.0 software was applied, and the overall survival was calculated using the Kaplan-Meier method. Results The median follow-up time was 30.9 months (5-67 months). Of all the 17 patients with assessable tumors, 9 cases (52.9%) were CR, 7 cases (41.2%) were PR, and 1 case (5.9%) was SD. Hematological toxicity was the severest side-effect that occurred in the procedure of CSI. The level 1-4 acute leukopenia were 8.7%, 30.4%, 34.8% and 21.7% and the level 1-4 acute thrombopenia were 8.7%, 30.4%, 21.7% and 8.7%, respectively. Conclusion For primary intracranial germinomas, HT can be used to implement CSI for simplifying radiotherapy procedures, improving radiotherapy accuracy, enhancing protection of peripheral organs at risk and guaranteeing therapeutic effects. With the acceptable acute and longterm toxicity, CSI using HT in intracranial germinoma patients is a safe and alternative mode.