Abstract： Objective： To investigate the correlation between the genotype and pathological grade of glioma and patients' tongue manifestation characteristics. Methods： A retrospective analysis was conducted on the pathological diagnosis data of 78 patients with glioma. Tongue manifestation images collected during multiple follow-up visits after surgery and concurrent chemoradiotherapy were reviewed. Tongue manifestation assessment was performed by two Chinese medicine practitioners， covering tongue body color， tongue body size， tongue body shape， tongue coating color，and tongue coating thickness. The correlation between tongue manifestation characteristics and different genotype subtypes and pathological grades was analyzed. Results：No significant correlation was found between the pathological grade of glioma and the five tongue manifestation characteristics. There was a significant correlation between IDH mutation， 1p19q codeletion， MGMT methylation and tongue body shape and size. No significant correlation was observed between IDH mutation，1p19q codeletion，MGMT methylation and tongue body color or tongue coating color. The IDH mutation and 1p19q codeletion showed a significant correlation with tongue coating thickness，whereas MGMT methylation showed no significant correlation with tongue coating thickness. Conclusion： The IDH mutation， 1p19q codeletion， and MGMT methylation in glioma are correlated with certain tongue manifestation characteristics， suggesting that tongue manifestation may hold potential value in assessing the condition of glioma.