With advances in neurosurgery, diagnostic radiology techniques and treatment, the outcome and prognosis of intracranial metastases have improved. The idea of surgery combined with postoperative radiotherapy has been accepted by many, and the combined treatment has demonstrated promising therapeutic prospects. The predominance of surgical resection of metastases in the overall treatment has been confirmed by many prospective studies. Surgical resection of metastases is not suitable for all cases and has strict indications: only patients with brain metastases that are (1) located at operable sites, accounting for approximately 20%-25% of brain metastases; (2) located at operable sites with multiple brain metastases, especially if they are not sensitive to radiotherapy or chemotherapy (e.g., melanomaa, kidney cancer), or if the lesions are too large for (3) among the multiple brain metastases sensitive to radiotherapy, there are life-threatening larger tumors, which can be removed first and then treated with radiotherapy; (4) it is difficult to differentiate from other intracranial lesions (such as meningioma, abscess, hematoma, etc.); (5) there is life-threatening intracranial hemorrhage; (6) there are symptoms of malignant pain that require the placement of Ommaya reservoir for intrathecal or intracerebroventricular (6) with symptoms of malignant pain, Ommaya reservoir should be placed for intrathecal or intracerebroventricular injection of chemotherapy drugs or opiates; (7) with hydrocephalus, shunt surgery is required. Analysis of surgical efficacy: Since most brain metastases are superficially located and not rich in blood supply, they are easily resected, especially with the use of microsurgical techniques, lasers, ultrasonic shock-absorbing systems (CUSA), stereotactic and neuronavigation devices, total resection of the tumor is not difficult and generally does not increase postoperative neurological deficits, thus creating the necessary conditions for other postoperative treatments. The standard surgical mortality rate for brain metastases, defined as mortality at 1 month postoperatively, has declined from 25 to 48% in the 1960s to 11 to 21% (Black, 1979) and 5 to 10% (Galicich, 1985, 1996). Surgical mortality is generally less related to the surgery itself than to the patient’s preoperative systemic condition and neurological dysfunction. Many retrospective studies have demonstrated that the survival rate after surgery alone is higher than that after radiotherapy alone, and is significantly higher if radiotherapy is combined with surgery. Patchell et al. observed the treatment of 48 cases of brain metastases by means of a prospective randomized controlled study and found that the survival rate in the surgery + radiotherapy group was significantly higher than that in the radiotherapy alone group, at 40 and 15 weeks, respectively. It has also been found that even in multiple brain metastases, total surgery achieved similar results to single brain metastases (mean survival time of 14 months), while partial resection of multiple brain metastases had a mean survival time of 6 months.