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Aim of this study was to systematically review the literature to assess efficacy and safety of stereotactic radiotherapy (SRT) in combination with immunotherapy for the treatment of melanoma brain metastases (MBM). The literature was searched using PubMed, Scopus, and Embase. Studies comparing SRT
plus
immunotherapy
versus
SRT or immunotherapy alone were deemed eligible for inclusion. Two studies showed improved overall survival after SRT
plus
immunotherapy in melanoma cancer patients with brain metastases. Three studies reported data on LC and DFS showing as SRT
plus
immunotherapy did not improve local control and DFS rates. G3-G4 toxicity was reported in only one study (20% in the SRT
plus
immunotherapy group
versus
23% in the immunotherapy group). Despite SRT
plus
concurrent immunotherapy seems associated with possible survival advantage and low ≥ G3 late toxicity rates, the quality of evidence is very low. Therefore, in patients with brain metastases from melanoma, SRT
plus
immunotherapy should be evaluated on an individual basis after discussion by a multidisciplinary team.