Hypofractionated radiosurgery either through frame or image guidance has emerged as the most important area of research and development for intracranial and extracranial radiosurgery. In this chapter, we focused on discussions of three state-of-the-art platforms: Frame-and Image-Guided Gamma Knife, Robotic X-Band Cykerknife, and Flattening-Filter-Free intensity-modulated S-band medical linear accelerators. Practical principles with detailed workflow and clinical implementations are presented in

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... a systematic approach. With rapid evolvement of both hardware and software in the realm of delivering hypofractionated radiosurgery, this chapter aims to offer a reader physical clarity on judging and balancing of achieving high-precision and highquality treatments with practical examples and guidelines on intracranial applications.