24 adult patients with brain metastases were reviewed retrospectively. Patients presented with single or multiple (<4) lesions but with controlled primary and not having any active primary or other metastases, and with Karnofsky performance score > 70. Patients were managed by either stereotactic radiosurgery (10 patients) or surgery (14 patients). All patients were given whole brain radiotherapy in the form of a total dose of 3000 Gy in 10 fractions over two weeks before radiosurgery (group I) and after surgery (group II). Patients were followed up at regular intervals by clinical and radiological assessment. Our results showed that patients with single brain lesion were treated more with surgery, while patients with 3 lesions per patient were treated more with radiosurgery. Small volume lesions were treated more with radiosurgery (mean 2.5 mL). No difference in the modality of management for supratentorial lesions while infratentorial lesions were treated more by surgery but multiple lesions (supra and infratentorial) were treated more with radiosurgery. The tumor control rate was 80% in radiosurgery compared to 92% in surgery six months after treatment, while it was 85% and 90% respectively one year after treatment. Disease free period was slightly longer in surgery group. Overall survival mean was 12.5 months in radiosurgery group and 13.6 months in surgery group. The Karnofsky status remained stable throughout…the follow up period.