Abstract: Objective To analyze the efficacy and side effects of gamma knife for orbit apex cavernous hemangioma. Methods From Mar. 2005 to Jun. 2013 in our hospital, 16 cases of orbital apex cavernous hemangioma were treated with gamma knife to perform fractionated stereotactic radiotherapy. A total dose was prescribed to the targets in 6-20 fractions of 2.3-5 Gy each. Visual acuity， visual field， the degree of exophthalmos and orbital MRI should be tested before treatment and at about each 6 months post-treatment. The median followed-up time was 21months（12-111 months） and ended in July 2014. Results All the tumors shrank in different degrees，including 5 cases of CR， 7 cases of PR and 4 cases of SD. The tumor response rate was 75.0％， and tumor control rate was 100.0％. The preservation rate of vision acuity was 81.3 ％（10 cases increased， 1 case kept stable and 2 cases decreased mildly）. Three cases with a visual acuity of hand movements or light perception disappeared. The improvement rate of vision field and exophthalmos were 81.3％ and 100.0％, respectively. All the symptoms including ambiopa， orbital ache and dizziness were disappeared. During the treatment, 3 cases showed mild acute reaction. The differences of the local efficacy and visual acuity change in all the dose groups were not significant（P＞0.05）. Before and after treatment， visual acuity（0.310±0.324 vs. 0.625±0.477）and exophthalmos（15.500±2.066 mm vs. 14.875±1.708 mm） improved and there were statistical significance（P=0.001，P=0.007），respectively. Conclusion Gamma knife-stereotactic radiotherapy treatment for orbital apex cavernous hemangioma is safe and effective with the effect of improving visual function and exophthalmos.