The development of improved immobilization systems, and a greater understanding of the radiobiologic considerations associated with stereotactic radiotherapy has recently led to the clinical implementation of this technology to extracranial sites. The shared principles of targeting and treatment delivery has led to a greater understanding of the potential role this therapy may have in the management of extracranial disease. This article will review , the radiobiologic considerations and the basic principles of physics and dosimetry that help govern the utilization of extracranial stereotactic radiotherapy. In addition, this article will summarize the data that exists in the literature to date, that has documented the rationale, and efficacy of this novel therapeutic approach.