Aim:Tumors of the endolymphatic sac are locally invasive temporal bone neoplasms. Radical surgical excision is the treatment of choice; however, the aggressive nature of these tumors can make total excision impossible. Recurrence is common in cases of incomplete resection.Material and Methods:Gamma knife radiosurgery was used to treat two patients with primary tumors of the endolymphatic sac and one recurrent case. Results:All three patients were alive at 75, 74,and 11 months,respectively, after gamma-knife treatment, and the tumors were either smaller or had not enlarged. None of the patients experienced radiation-related side effects during follow up. Conclusion:Gamma knife radiosurgery should be considered a treatment option for these surgically challenging tumors.