Behavioral studies have documented impaired working memory in childhood brain tumor survivors; however, neural mechanisms have yet to be identified using fMRI. The current study investigated BOLD response differences between twenty survivors (Mean age=23.1(4.14), 55% female) and twenty age- and gender-matched controls from the start to the end of a twenty minute 3-back task. There were no differences in task performance between groups or over time. Effects of practice were present in left prefrontal regions, with both groups showing decreases in activation as the task progressed. There were qualitative and quantitative differences in the brain regions that survivors recruited relative to controls in bilateral prefrontal (including the dorsolateral prefrontal cortex) and parietal cortices. Findings suggest that areas under top-down control of the dorsolateral prefrontal cortex become less activated with practice, and that survivors may require more top-down processing and attentional control to perform at similar levels to healthy controls.