The concepts for neurosurgeons and radio-oncologists have been changed during the last decade andrnhave also transformed neurosurgery. Stereotactic radiosurgery is related to the history of “radiotherapy”rnand “stereotactic neurosurgery”. The gamma knife and the stereotactically modified linear acceleratorrn(LINAC) are radiosurgical equipments to treat predetermined intracranial targets through the intact skullrnwithout damaging the surrounding normal brain tissue. Histological determination by stereotactic biopsyrnremains the basis for any otherwise undefined intracranial lesion. The impact of radiosurgery is presentedrnfor the management of gliomas, metastases, brain stem lesions, benign tumours and vascularrnmalformations and selected functional disorders such as trigeminal neuralgia. In AVM’s it can bernperformed as part of a multimodality strategy including resection or endovascular embolisation. Finally,rnthe technological advances in radiation oncology as well as stereotactic neurosurgery have led tornsignificant improvements in radiosurgical treatment opportunities. The combination of both, thernneurosurgical and the radio-oncological expertise, will help to minimize the risk for the patient whilernachieving a greater treatment success.