During 4 years we have treated 202 patients with meningiomas using the Leksell γ knife. The results in 156 patients with a postoperative follow-up of at least 6 months were assessed. Collateral edema after radiosurgery occurred in 16 patients (10.3%), and in 8 patients it was asymptomatic. The collateral postirradiation edema gradually improved in 14 patients. The tumor volume increased in 10 patients. In seven patients, enlargement caused by intratumoral edema was temporary and a subsequent decrease in tumor volume was observed. In three patients there was real growth after radiosurgery; in two cases the meningioma was malignant and in one patient the tumor volume was underestimated for radiosurgery. Shrinkage of the tumor was observed in 59 patients (38%). An improvement in the clinical state was observed in 48 patients (31%). An impairment of neurodeficit was observed in 10 patients (6.4%), in 6 patients after the antiedematic corticotherapy neurodeficit gradually improved. An average dose of 13.5 Gy to the tumor margin was applied. The optimal marginal dose for meningioma seems to be in the range of 12–16 Gy. Radiosurgery is a noninvasive treatment method suitable as an alternative treatment for meningiomas when the immediate decompressive effect of open neurosurgery is not necessary.