The best way to manage small and medium sized vestibular schwannomas is currently a matter of heated debate. As these tumors are not immediately life-threatening, patients are invariably concerned about how management would affect their quality of life. In comparison with microsurgical resection of vestibular schwannomas, radiosurgery has a lower morbidity rate, a similar risk of requiring further surgery, and higher patient satisfaction. As this information becomes more widely available, radiosurgery may replace surgical resection as the preferred management strategy for patients with small to medium sized vestibular schwannomas This work evaluates the applicability and effectiveness of gamma knife stereotactic radiosurgery as a treatment modality for vestibular schwannoma. It also reviews the use of gamma knife radiosurgery as a safe and efficient alternative therapy.