Aim:Surgery alone is not an adequate treatment option for brain metastases due to high local recurrence rates, therefore adjuvant radiotherapy is recommended. Because of the concerns about deterioration in neurocognitive functions with adjuvant whole brain radiotherapy (WBRT), and difficulties in target delineation and increased risk of radionecrosis (RN) and leptomeningeal dissemination with adjuvant stereotactic radiosurgery (SRS); pre-operative SRS has emerged as an alternative strategy which is anticipated to overcome these challenges.Material and Methods:We identified 18 patients who underwent preoperative SRS in our clinic between 2015 and 2021. Two patients were lost to follow-up and therefore were excluded from clinical outcome analyses. SRS was administered using the CyberKnife system. Results:The median volume of index lesion was 14,19 mL (range 3,13-40,84). SRS was performed in median 1 fraction (range 1-2) to a median prescription dose of 15 Gy (range 12-17). Gross total resection was achieved in 14 (77.8%) patients. The median follow-up was 15 months (range 1-87). Median cancer specific survival (CSS) was 31 months. 6-, 12- and 24- months local control (LC) rates were 91%, 79% and 68%, respectively. Better gross tumor volume coverage was associated with better LC (p:0,01). 6-, 12- and 24- months distant brain control (DBC) rates were 82%, 58% and 47 %, respectively. Infratentorial location of index lesion was associated with worse DBC (p:0,026). None of the failures were in the pattern of leptomeningeal dissemination (LMD). Grade IV symptomatic RN was reported in a single case. Three patients experienced fatal (grade V) post-operative complications.Conclusion:Preoperative SRS approach, which provides the advantage of low rates of RN and LMD, is a meritorious alternative strategy in the treatment of brain metastasis. Care must be given to better assessment of surgical mortality and the selection of appropriate patients for this treatment approach.