Non-germinomatous germ cell tumours of the central nervous system (CNS NG-GCT) have no standardized treatment at relapse and prognosis is dismal. Additionally, limited patient numbers preclude any clinical trials in this setting. Here we report the case of an adolescent with relapsed metastatic pineal yolk sac tumour treated with induction chemotherapy, high dose chemotherapy followed by autologous stem cell transplant and radiotherapy who is alive and progression-free 5 years after end of treatment. This experience illustrates the importance of tumour marker surveillance and that multimodal treatment can salvage children with relapsed CNS NG-GCT.