Abstract: Objective To explore the consistency of results of molecular pathology and histopathology in patients with glioma and the role of molecular pathology in improving the accuracy of pathological diagnosis in glioma. Methods Eighty-nine patients with glioma(25 low-grade gliomas, 64 high-grade gliomas) were treated in neurosurgery department of the First Medical Center of Chinese PLA General Hospital from January 2017 to May 2018, and their molecular pathological and histopathological results were retrospectively analyzed. Then diagnostic consistency of the corresponding indicators between two groups was investigated.Patients with gliomas were divided into high-grade glioma group and low-grade glioma group, and the molecular and pathological diagnosis consistency rates of the two groups were statistically analyzed. Results The consistency rate of molecular pathology and histopathology in diagnosis of glioma grade was 79.8%. The diagnostic agreement rates of histopathology and molecular pathology were 93.3% and 57.3%, 79.8%, respectively. In terms of judging IDH-1 mutation, MGMT methylation and ATRX mutation, the accuracy were improved by 6.7%, 42.7%, and 20.2%, respectively. There was significant difference in the diagnostic agreement rate of MGMT methylation between high-grade glioma group and low-grade glioma group(76.0% vs 50.0%, P=0.026), but no difference in comprehensive pathological diagnosis type, IDH-1 mutation, ATRX mutation. Conclusion The diagnostic agreement rate of histopathology and molecular pathology is higher for IDH-1 mutation of glioma. While molecular pathology is more accurate in the comprehensive diagnosis of glioma grade, the diagnosis of MGMT methylation and ATRX mutations.