In early experience, radiosurgery proved to be a relatively safe and effective therapy for selected patients with symptomatic meningiomas, including those for whom surgical resection failed. Radiosurgery also has been an effective primary treatment alternative for patients whose advanced age, medical condition, or high-risk tumor location preclude microsurgery. The long-term response to treatment, as defined by imaging and clinical findings, is not yet available. In addition, further clinical and laboratory work is necessary to determine the appropriate tumoricidal radiosurgical dose, dose-volume relationships for individual tumors, and the variable radiation tolerance of the different brain structures that closely surround meningiomas.