Objective To retrospectively analyze and evaluate the therapeutic effect of gamma knife on cavernous hemangioma of the cavernous sinus. Methods Gamma knife was applied to treat 33 cases of cavernous hemangioma of the cavernous sinus, of which 10 cases were postoperative residual and 23 cases were diagnosed by imaging. The mean tumor diameter was 29 mm (12-65 mm). The mean peripheral dose was 12.5 Gy (9-16 Gy), and the mean isodose curve was 47.7% (40-50%). Results Thirty-two patients were followed up with a mean follow-up time of 46 months (6-135 months). Symptom changes: 30 cases (93.8%) showed significant improvement or disappearance of symptoms after treatment, and 2 cases (6.2%) were the same as before treatment. No other symptoms of impaired cranial nerve function appeared in this group after treatment. Tumor changes: 9 cases (28.1%) with basic disappearance of tumor, 21 cases (65.6%) with significant shrinkage, 2 cases (6.7%) with no significant change in volume compared with before gamma knife, total tumor control rate 100%. In this group, two patients were treated with Gamma Knife in stages because of the huge size of the tumor before treatment. Conclusion Gamma knife treatment of cavernous sinus cavernous hemangioma is safe and effective, and can effectively improve their clinical symptoms.