Recent progresses in treatment of brain metastases have improved survival and quality of life in cancer patients. Surgery and stereotactic radiosurgery are two validated technics for brain metastases treatment. Actually, these two modalities of treatment could be used separately or in combination depending on the clinical situation (age, primitive disease status, type of primitive cancer, Karnofsky performance status) and radiological situation (number of brain metastases, localization). In this article, data from trials that examine the role of surgery and stereotactic radiosurgery in the management of brain metastases are reviewed.