To compare the efficacy of continuous chemotherapy with simultaneous radiotherapy and radiotherapy alone and continuous chemotherapy after radiotherapy on adult thalamic glioma and the influence of different factors on the prognosis of adult thalamic glioma. Methods: For this study, 33 adult patients diagnosed with thalamic glioma were selected. All patients underwent tumor resection; 22 patients underwent synchronous chemotherapy during radiotherapy after surgery; 11 patients underwent radiotherapy alone after surgery; 20 patients were treated with continuous chemotherapy after radiotherapy (of these, 15 patients underwent continuous chemotherapy after synchronous chemotherapy during radiotherapy and 5 patients underwent continuous chemotherapy after radiotherapy alone). The efficacy of different combinations of treatment regimens and the patient survival rate at 6 months, 1 year, and 2 years were analyzed and compared. Results: After resection surgery, 5 patients experienced postoperative hydrocephalus, and ventriculoperitoneal shunting was employed for treatment. The average follow-up time was (18.62±5.32) months. Of all patients, the median survival period was (17.40 ± 6.71) months. The 6-month, 1-, and 2-year overall survival rate was respectively 81.82%, 69.70%, and 48.48%. Univariate analysis displayed that the factors that affect overall survival rate of patients with thalamic glioma include WHO grade (P<0.05), duration of disease (P<0.05), and synchronous radiotherapy (P<0.05). Multivariate analysis showed that patients with low WHO grade, short disease course, and concurrent chemoradiotherapy received better prognoses (P<0.05). Conclusion: Pathological WHO grade, course of disease, and synchronous chemotherapy during radiotherapy are the main factors affecting the prognosis of adult thalamic gliomas. Synchronous radiotherapy is superior to radiotherapy alone in the treatment of adult thalamic gliomas, and whether continuous chemotherapy is utlized after radiotherapy shows no significant difference.