Brain metastases (BM) are a leading cause of morbidity and mortality in patients with systemic cancer. In the last two decades, an enormous improvement in controlling extra-cranial disease has been achieved, positively affecting the overall survival of patients. However, this has led to an increased number of patients who live long enough to develop BM. In addition, technological improvements in neurosurgery and radiotherapy caused both surgical resection and stereotactic radiosurgery (SRS) to become an integral part of the armamentarium when treating a patient with 1-4 BM. These increased therapeutic possibilities and combination of therapeutic options such as surgical resection, SRS, whole brain radiation therapy (WBRT) and lately targeted molecular therapy, have led to an enormous amount of, yet sometimes confusing, published data.