Radiosurgery offers patients with brain metastases an effective and minimally invasive treatment modality. Radiosurgery provides local tumor control and prolongs survival in select patients with brain metastases. This review will discuss numerous aspects of radiosurgery, including the various delivery techniques and radiobiology. Treatment recommendations will be outlined in view of the available clinical data. Although surgery or radiosurgery with whole-brain radiotherapy remains an important option for patients with a solitary brain metastasis, radiosurgery with or without whole-brain radiotherapy should be considered in patients with a limited number of small tumors and a good prognosis.