Cognitive deficits related to tumour or treatment are estimated to be present in the majority of patients diagnosed with a primary brain tumour, with a large variation based on tumour site, extent, and grade, as well as nature of intervention. These deficits have a significant impact on patient’s quality of life and functional status. The improved patient survival duration in recent years has increased the need to detect, understand and intervene on these cognitive deficits, and optimise patient pathways for treatment. This article reviews the nature of deficits arising in patients with primary brain tumour, and the association of the deficits with neuroanatomical site of tumour. The approach to interventions through adaptation and remediation is outlined, with aim of improving function, promoting generalization of outcomes and optimizing any neuroplasticity that may arise. The evidence for pharmacological therapies and cognitive rehabilitation is presented, and a framework for implementation is provided.