Medulloblastoma is a heterogeneous embryonal tumor in the cerebellum that occurs mostly among children with a poor prognosis. As one of the main characteristics of solid tumors, hypoxia plays an important role in tumor genesis. HIF-1α mediates hypoxia signaling in tumor cells, and meanwhile regulates the expression of genes related to tumor progression, angiogenesis, cell survival and invasion. It has been confirmed that HIF-1α regulates the growth of medulloblastoma through a variety of pathways, while few reviews have specifically focused on the roles of HIF-1α in medulloblastoma. In this review, we will discuss the regulatory mechanism and the prospects of drug-resistance therapeutic targets in medulloblastoma.