Abstract INTRODUCTION Intracranial hemangioblastoma is a rare neoplasm that poses significant challenges in clinical management. Hemangioblastomas are characterized by unique radiological features into cystic or solid tumors. Out study aims to evaluate the role of SRS in the management of cystic and solid hemangioblastomas in a single institution setting. METHODS We conducted a retrospective analysis of clinical and radiological outcomes of patients with intracranial hemangioblastomas treated with CyberKnife SRS at our institute between 1998 and 2023. The follow-up data were available for 93 intracranial hemangioblastomas in 23 patients. Ten (43.5%) patients presented with 23 (25.6%) cystic hemangioblastomas, while 13 (56.5%) patients had 70 (75.3%) solid hemangioblastomas at the time of SRS treatment. The median age was 36 years and the median tumor volume accounted for 0.43 cc. The SRS was administered with the median single-fraction equivalent dose (SFED) of 20 Gy at the 77% of the median isodose line. RESULTS At a one-year follow-up, 11 initially solid hemangioblastomas developed cystic formation, resulting in a total of 34 (36.6%) cystic hemangioblastomas and 59 (63.4%) solid hemangioblastomas across 13 and 10 patients, respectively. Among these, 84.6% exhibited peritumoral edema prior to the onset of cystic formation. For 37 solid hemangioblastomas accompanied by peritumoral edema, SRS was administered before cystic transformation, remaining solid throughout the latest follow-up. Over a median follow-up period of 59 months (range: 3-260), 6 (17.6%) cystic and 13 (22%) solid hemangioblastomas progressed. The 5-year local tumor control (LTC) rate for intracranial hemangioblastomas was 84.7%, with 97% and 76.9% in cystic and solid lesions, respectively. CONCLUSION Our study illustrates the largest single-institutional long-term retrospective analysis of intracranial hemangioblastomas treated with SRS to date. Early SRS treatment at the time of edema may prevent cystic hemangioblastoma development and provides durable treatment outcomes for patients with both cystic and solid hemangioblastomas in long-term.