Due to continually improving treatment options for malignant tumors, the incidence of brain metastases is increasing. Bronchial carcinoma, breast cancer, and malignant melanoma are the most frequently diagnosed primary tumors. Treatment requires an interdisciplinary approach with consideration of various different factors, including primary tumor histology, overall prognosis, the number of brain metastases, and extracerebral metastasis. Possible therapeutic options are tumor resection or radiosurgery as local treatment, whole-brain irradiation as regional treatment, chemo- or immunotherapy as systemic treatment, and best supportive care as a symptomatic treatment approach. Establishment of the indications for each treatment and the subsequent procedures are described in detail. Furthermore, the different treatments are classified according to their value.