Surgery, radiation therapy, chemotherapy, steroid therapy and radiosurgery have been the mainstream of management of brain metastasis and the trend has been continuously changed along with the advancement of cancer management, development of new technology and changing in perception of quality of life. A glance at the historical perspective on brain metastasis management clearly shows two major shifts which have been made in last two decades. One is the changes of leading treatment modalities from whole-brain radiation therapy to multimodal management focusing on radiosurgery, and the other is changes of the attitude of the treatment from palliative purpose to disease control. The epoch-making change in the understanding of brain metastasis is that brain metastasis is no longer a death sentence as considered in the past.