211 patients operated on for brain metastases have been selected through a review of specimens from the Department of Pathology of the University of Florence covering the period between 1980 to 1995. 140 patients (66%) are males and 71 (34%) are females. Average age is 59 years ranging from 33 to 79 years of age. Lung tumours (47%) and breast cancer (9%) are most frequently responsible for brain metastases. In 17% of the patients, the primary lesion was unknown. The average survival was 14 months and in 8 patients (4%) it was more 5 years. In 36 cases (17%) recurrence appeared 8 months after the first operation. Survival in these patients averaged 20 months from the diagnosis of brain metastases and 11 months after the discovery of the relapses. It is not significantly different from that of patients without evidence of relapsed metastases in the brain (13 months). Prognostically renal carcinoma behaves more favourably, average survival (27 months); on the contrary prognosis of metastatic melanoma is ominous (7 months). Metastases from unknown primaries do not have a significant different prognosis from all the other lesions.