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<p>O⁶-methylguanine-DNA methyltransferase (MGMT) is an important DNA repair enzyme. The promoter methylation status of <em>MGMT</em> gene has recently become a biomarker of gliomas. Methylation of the <em>MGMT</em> promoter not only is an important biomarker to evaluate the sensitivity to the chemotherapy with alkylating agents, but also contributes to predicting prognosis and distinguishing between recurrence and pseudoprogression in glioma patients. Especially in the elderly, <em>MGMT</em> promoter methylation status has recently been introduced to be a biomarker for glioma classification and personalized treatment strategies. This review gives a short summary of the function of MGMT and clinical application of <em>MGMT </em>promoter methylation in personalized treatment strategies, prognosis evaluation and differentiation of recurrence and pseudoprogression of glioma.</p><p> </p><p>doi: 10.3969/j.issn.1672-6731.2014.07.017</p>