Radiosurgery has become a popular alternative to microsurgery for small arteriovenous malformations (AVM). Numerous reports document high obliteration rates (around 80%) and low radiation induced complication rates (around 2%). Gamma knife, linear accelerator, and particle beam systems are all viable options. The major drawback of radiosurgery is that the patient remains at risk for hemorrhage until the AVM is completely obliterated and this process typically takes around 2 years. The major advantages are that the treatment can be performed on a outpatient basis with local anesthesia and that the potential serious complications of embolization and open surgery can be avoided.