Background. Stereotactic radiosurgery (SRS) is a standard treatment method for patients with primary brain metastases regardless of their tumor nosology. At the same time, there are not any standard treatment methods for recurrent brain metastases, which have a significantly worse prognosis. Our own experience and literature data indicate that the combination of radiation therapy and antiangiogenic targeted drug bevacizumab (BEV) improves treatment results in both primary malignant and metastatic tumors of the brain. Purpose – to assess the efficacy and safety of BEV in repeated radiosurgery of recurrent brain metastases after high-dose radiation therapy. Materials and methods. The prospective unicentral nonrandomized study was conducted in the State Institution «Romodanov Neurosurgery Institute of the National Academy of Medical Sciences of Ukraine» (2017–2024). It involved a sample of 16 patients with recurrent brain metastases of the most common tumor nosologies to the brain. The patients previously received high-dose radiosurgical treatment for primary brain metastases. In cases of metastatic recurrence, both single-fraction and multi-fraction radiosurgery were used. They were performed using the Trilogy linear accelerator with bremsstrahlung energy of 6 MeV. The dose ranged from 15 to 22.5 Gy. BEV was used as an adjuvant drug in all patients after radiation therapy to decrease symptoms of radiotoxicity and worsening of quality of life caused by it. The patients received from 2 to 18 courses of BEV at a dose of 10 mg/kg of weight with an interval of 3 weeks. We conducted an overall survival analysis of patients who received BEV after radiosurgical treatment of recurrent brain metastases. Results. The time of development of recurrent brain metastases after the first high-dose SRS ranged from 7 to 18 months with a median survival of 12 months. The patients were receiving radiosurgical treatment for recurrent brain metastases in combination with BEV from May 2019 to December 2023. One-year overall survival was 68.7% with a median of 21 months, which surpassed the median survival after the first radiosurgery by 9 months. The neurological deficit fully regressed in 9 patients (56.3%). In other patients, significant neurological improvement was achieved. At the time of analysis, 8 patients were still followed up. The use of BEV in patients with brain metastases after radiosurgical treatment demonstrated an acceptable toxicity profile. According to CTCAE v5.0, no cases of grade 3–5 adverse events were registered. MRI imaging over the course of time showed a positive response in terms of achieving local control in 87.6% of cases. Conclusions. The use of BEV allows toxic symptoms of repeated radiosurgical treatment to be minimized and the duration and quality of life of patients to be improved. The clinical effect was supported by a clear radiological response according to the MRI imaging data.