Vestibular schwannoma(acoustic neuroma) has its special natural history.Some tumors with severe symptoms grow fast,some slowly,some even stop growing,and some recur after resection.People focus their attention on these problems.The articles about the pathogenesis of vestibular schwannoma covering recent ten years were reviewed.The relationship between clinical manifestations and genotypic expression was definite in the family vestibular schwannoma,but not very clear in the sporadic one.The inactivating of neurofibromatosis type 2 gene plays a role in the early stage of tumor;maybe there are other genes accounting for the regulation of the tumor differentiation.A further study is needed.