From February 1989 to December 1993, 139 patients with a variety of brain lesions were treated with stereotactic external beam irradiation using a 6MV linear accelerator. The largest group consisted of patients with recurrent brain metastases (n = 46). Twenty seven patients had malignant gliomas, most of which were recurrent. Several benign conditions were treated, including arteriovenous malformations (n = 27), acoustic neuromas (n = 9), meningiomas (n = 7), and pituitary adenomas (n = 2). Durable responses were seen in the majority of patients with transient, mild, side effects. This experience suggests that stereotactic external beam irradiation is a safe, reliable, and effective method for non-invasive treatment of selected patients with small, localized brain lesions.