The update to the CNS/AANS-sponsored Guidelines for the Management of Brain Metastases, led by the Tumor Section and initially published in 2010, is published electronically as of January 2019 and in hard copy (Neurosurgery) in March 2019. This is another in a series of evidence-based guideline projects directed by the Tumor Section and created to provide the most objective, literature-supported guidance possible for those involved in the management of brain tumors. A multidisciplinary panel of physicians assembled to address clinically pertinent management questions related to metastatic brain tumor treatment. The objectives of these guidelines are to establish the best evidence-based management of metastatic brain tumors in terms of whole brain radiation therapy, surgery, stereotactic radiosurgery, chemotherapy, prophylactic anticonvulsants, steroids and instances of multiple brain metastases. Important changes from the original set of guidelines include recommendations reflecting the evolution of metastatic brain tumor management away from the use of whole brain radiation therapy, in favor of the more focal therapies of stereotactic radiosurgery, surgical techniques and their adjuncts. The recommendations about the use of corticosteroids in symptomatic cerebral edema and the narrow application of anticonvulsants with this set of lesions has changed little over the interval since 2010. These guidelines serve as a benchmark from the literature regarding what we do know about the management of this set of tumors. More importantly, it tells us what we do not know about metastatic brain tumor management and serves as a platform for future clinical research. Executive summary and full text versions of these guidelines are available via the CNS website and the freely available CNS Guidelines in Neurosurgery application.