The analysis of cost issues has become increasingly important in all fields of medicine. Understanding these economic analyses can make providers more cognizant of the ultimate health, economic, and social outcomes of their treatment decisions. The methodology of cost studies and the surgical costs of treatment of intracranial metastatic tumors warrant review. Costs of surgical and radiosurgical treatment are in the range of that for the care of other serious illnesses, but comparison of the available options is still sensitive to assumptions, and open to varied interpretations.