Abstract： Objective The aim of this study was to assess the long term clinical outcomes of the gamma radiosurgery (GKS) for vestibular schwannomas (VS).Methods Duaring the period from December 1994 to December 2000,197 patients with VS received GKS more than 10 years and 157 patients were followed up with MRI( follow -up rate was 80.0％ ),which included 75 males and 82 females.The Leksell Gamma Knife models B was used.The mean age of the patients was 51.4 years( 10 to 77 years).GKS was applied as primary treatment for 125 cases(79.6％ ),and was an adjunctive management approach for 32 cases (20.4％ ).The mean peripheral dose was 12.7 Gy (range 8.0 ～14.4 Gy)and the mean central dose was 28.8 Gy(range 20～40 Gy).The mean volume was 5.1 cm3( range 0.037 ～ 27.300 cm3 ).The mean follow - up period was 6.3 years ( 1 - 15 years).Results Of this 157 cases,93 cases (59.2％ ) showed shrinkage,48 cases ( 30.6％ ) remained stable,16 cases ( 10.2％ ) showed tumor development,and the overall tumor control rate was 89.8％.7 cases died of other causes during the period of follow up and benefit from GKS all their lives.The actuarial 3 -years、5 -years and 10 years tumor control rate were 94％ 、92％and 87％ respectively.The actuarial 3 -years、5 -years and 10 years hearing preservation rate were 94％、85％ and 64％ respectively.The rate of permanent and marked facial paralysis and trigeminal neuropathies was 0.0％,the rate of transient facial paralysis was 16.6％,and the incidence of transient trigeminal neuropathies were 17.8％.Conclusion With a 12 ～ 14 Gy peripheral prescription dose,GKS was confirmed to have a long term tumor control for small to mediate sized and maintainance of a high quality of life,and could prevent cranial nerve from injury to a great extent.Duaring the long term follow -up period there might be not an end poit due to future reccurrence of VS.