--- - |2+ Abstract Background Evidence has shown that survivors of pediatric brain tumors have more negative psychological sequelae, particularly depression, than do survivors of other childhood cancers. This study examined the efficacy of a musical training program in reducing depressive symptoms, and enhancing self‐esteem and quality of life in Hong Kong Chinese pediatric brain tumor survivors. Methods A prospective randomized controlled trial, two‐group pretest and repeated post‐test, between‐subjects design was conducted to 60 pediatric brain tumor survivors (8‐ to 15‐year‐olds). Participants in the experimental group received a weekly 45‐minute lesson on musical training for 52 weeks. Participants in the control group received a placebo intervention. The primary outcome was depressive symptoms at 12 months. Secondary outcomes were self‐esteem and quality of life at 12 months. Data were collected at baseline, and 6 and 12 months after the intervention began. Results Participants in the experimental group reported statistically significant fewer depressive symptoms (P < .001), higher levels of self‐esteem (P < .001), and better quality of life (P < .001) than the control group at 12‐month follow‐up. Conclusions This study provides evidence that musical training is effective in reducing depressive symptoms, and enhancing self‐esteem and quality of life in Hong Kong Chinese pediatric brain tumor survivors. These results indicate that musical training is not only a leisure activity, but carries therapeutic effects in promoting psychological well‐being and quality of life in pediatric brain tumor survivors. - Psycho-Oncology, Volume 0, Issue ja, -Not available-.