Serial tomotherapy is a technique that allows slice by slice treatment of intracranial targets using an intensity modulated radio therapeutic algorithm and a Linear Accelerator.In the last 2 years we have been using this technique extensively in over 150 patients with a variety of intracranial/head and neck neoplastic pathologies.The nature of the pathology varied from meningioma to brain metastases to acoustic neuromas to primary intracranial malignant gliomas to head and neck malignancies.The target volume varied from 1 cc to more than 480cc.Fractionation ranged from 1 to 34 fractions.While the ultimate outcome depended on the nature of the lesion, the degree of control was comparable and in some pathologies better that what was observed with different stereotactic radiotherapeutical/ radiosurgical techniques.The versatility of changing fractionation regimens and the lack of target volume/shape limitation make this radiosurgical/radiotherapeutic modality very attractive.In addition the limited cost and capital investment, when compared to other radiosurgical/radiotherapeutic implementations, makes this technique affordable by a more numerous cohort of health delivery systems and hence available to more patients.