The management of intracranial germinomas is controversial, with treatment options including conventional wide-field irradiation with or without chemotherapy or primary chemotherapy alone. The potential role of radiosurgery in the treatment of these lesions, although appealing, remains to be defined. We report a case whose initial management plan included radiosurgery to be followed by chemotherapy; however the patient subsequently refused chemotherapy. The presentation, diagnosis, treatment and results are discussed.