For patients suffering from brain tumors, it is very important to make the right choice between traditional surgery (open and minimally invasive) and Gamma Knife surgery. The first thing to do is to dispel the misconception that Gamma Knife is risk-free. Gamma knife is used to destroy tumor cell activity by focusing gamma rays on the tumor, but it may also damage adjacent structures around the tumor, such as important nerves, leading to serious complications; gamma knife can also cause large edema and delayed necrosis of the peri-tumor brain tissue. Traditional surgery has been practiced by several generations of neurosurgeons and is now able to achieve almost perfect results for many tumors in many sites. The choice of two treatment modalities for a specific tumor depends on many factors such as its nature, location, size, patient’s physical condition and age. Gliomas cannot be treated with Gamma Knife in principle, on the grounds that they are insensitive to gamma radiation. Metastases are preferred to gamma knife treatment because they are usually very sensitive, but it depends on the size, too large metastases, compression has been very obvious, gamma knife treatment “distant water can not be near the fire”, then you can choose craniotomy. For meningioma, huge meningioma usually need to open cranial surgery, while smaller meningioma, if the location is deep in, the risk of surgery is too great, can be the second best choice gamma knife. Spongiform hemangioma, gamma knife is ineffective, conventional surgery is preferred, but spongiform hemangioma in the cavernous sinus is a special case, and gamma knife is preferred for treatment. For auditory neuroma, surgery is preferred over 3 cm, and gamma knife can be considered for treatment below 3 cm, but for elderly and frail patients, gamma knife can also be considered over 3 cm due to poor ability to tolerate surgery. Since there are many types of intracranial tumors, it is impossible to give examples of each one. In short, it is necessary to consider various factors to neutralize the judgment. In recent years, the gamma knife has become more and more popular, and in practice, the phenomenon of misuse of gamma knife treatment has increased significantly. Patients in the choice, or according to the doctor’s advice, careful judgment.