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Corresponding author: Yutaka NaoiDepartment of Radiation Oncology, Juntendo University Nerima Hospital3-1-10 Takanodai, Nerima-ku, Tokyo 177-8521, JapanTEL: +81-3-5923-3111　E-mail: y.naoi@juntendo-nerima.jp355th Triannual Meeting of the Juntendo Medical Society “Farewell Lectures of Retiring Professors” 〔Held on Mar. 30, 2022〕〔Received　Jul. 7, 2022〕〔Accepted　Aug. 8, 2022〕J-STAGE Advance published date: Oct. 15, 2022Copyright © 2022 The Juntendo Medical Society. This is an open access article distributed under the terms of Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original source is properly credited. doi: 10.14789/jmj.JMJ22-0029-R　Juntendo University Hospital is the second hospital in Japan to start stereotactic brain irradiation using linear accelerator (LINAC) system. This report details the historical transition of stereotactic irradiation, progress of treatment technology, and change of treatment method from the beginning to the Juntendo University Hospital and Juntendo Nerima Hospital. The hospital changed the use of cobalt to the LINAC system when it was rebuilt in 1993. Total body irradiation treatment for leukemia had started around the same time. A year later, in 1994, the hospital used their LINAC systems to perform stereotactic head irradiation, otherwise known as pinpoint irradiation. In 2005, Juntendo University Nerima Hospital was opened and in September of the same year, radiation therapy using the latest model of LINAC system at that time was initiated. This was the first among all Juntendo hospitals to start intensity-modulated radiation therapy (IMRT) and image-guided radiotherapy (IGRT). In 2014, a second LINAC system for IMRT and IGRT was equipped at the Juntendo Hongo Hospital.　In 2021, the LINAC systems of the Juntendo University Nerima Hospital were replaced after 15 years of usage. The new method of SRS was started using a latest LINAC systems.　In this paper, I introduce the technique and progress of SRS that I have experienced mainly in Juntendo University.Juntendo Medical Journal2022. 68(5), 459-464Special ReviewsHistorical Review of Stereotactic Radiosurgery in Juntendo UniversityIntroductionThe Japan Radiological Society defines single stereotactic irradiation as stereotactic radiosurgery (SRS) and fractionated stereotactic irradiations as stereotactic radiotherapy (SRT), but in this manu-script, the term SRS is used without distinction. In Japan, SRS using the Gamma Knife was first started at the Tokyo University Hospital in 1991. Two years later, SRS using linear accelerator (LINAC) systems was performed at the Nagasaki Univer-sity. A year later, in 1994, the Juntendo University Hospital began SRS using the LINAC systems, making it the second facility in Japan to perform LINAC-based SRS. Since then, the LINAC-based treatment method has progressed along with the Key words: stereotactic radiosurgery, stereotactic radiotherapy, linear accelerator, Gamma KnifeDepartment of Radiation Oncology Juntendo University Nerima Hospital, Tokyo, Japantechnological development of the LINAC systems. I introduce the historical background and the devel-opment of SRS technique especially for Juntendo University Hospitals.Short history of Stereotactic Radiosurgery In 1968, the world’s first SRS was started with the Gamma Knife technology at the Karolinska Hospital in Sweden (Table 1). Twenty-three years later, the first Gamma Knife surgery in Japan was started at the University of Tokyo. The successful adoption of the LINAC system for SRS by the Juntendo University, Japan, led to a rapid develop-ment of LINAC devices and subsequent increase in the number of treatment facilities in Japan.459Yutaka NAOIfor brain in Japan