Lars Leksell performed the first Gamma Knife radiosurgery (GKS) procedure for Vestibular schwannoma (VS) in June 1969. Since then the increased acceptance of GKS for VS by the neurosurgery and neurootology communities is reflected as well in the evolution of management choices. Now GKS is thought to be a realistic, practical, and cost-effective alternative to surgery. More and more patients underwent GKS for vestibular schwannoma. The cumulative number of patients treated with GKS for VS by the end of 2011 was 64,000 worldwide and 15,000 in the U.S. (source of statistics: International Leksell Gamma Knife Society).
　　Since GKS plays a more important role now in the treatments for VS, innumerable peer-reviewed clinical outcome studies have been published in recent days contains in-depth and less dogmatic discussions of the role of radiosurgery in comparison with alternative treatments, including a discussion of many of the topics such as local control, functional outcomes, cranial nerve complications, volumetric changes, malignant transformation, management of neurofibromatosis Type 2, cochlear dose effects, options for large tumors, acute injury, technical parameters of radiosurgery, and the relative roles of observation, radiosurgery, and microsurgery.
　　In 1983, Taipei Veterans General Hospital treated the first GKS patient in Taiwan and was now one of the most active Gamma knife centers in the world. Till 2014 August, 738 VS patients had undergone GKS in Taipei Veterans General Hospital. Today we are going to share our treatment experience and also reviewed recent published clinical studies about GKS for VS.