Objective To investigate the therapeutic effect of radial surgery in large cerebral metastatic carcinoma. Methods Adopt three dimensional oriented radial surgery to 15 patients with the biggest diameter of more than 35mm. Observe the variation of clinical symptoms and analysis the change of CT image. Follow up the survival time, complications and the cause of death at the same time. Results Most of the patients got prominent improvement in symptoms. But the imaging change of carcinoma focus was a slow course comparatively. The survival rate in 1 year was 26% . Conclusion Radial surgery is an effective, simple and safe method in the treatment of large cerebral metastatic carcinoma. It has a good control rate with only slight complications.