Hemangioblastoma (HAB) is a benign, richly vascularized tumor that accounts for 2—6% of all spinal cord neoplasms and ranks third in the structure of intramedullary space-occupying lesions of the spinal cord. Hemangioblastoma may occur sporadically or, in approximately 30% of cases, as part of the clinical picture of a hereditary disease, von Hippel—Lindau disease. The aim of this study was to evaluate the efficacy and safety of stereotactic irradiation of hemangioblastomas of the spinal localization in patients with sporadic and von Hippel—Lindau-associated hemangioblastomas The results of stereotactic radiotherapy were evaluation of 210 spinal hemangioblastomas in 74 patients. Follow-up observation was available for 67 patients with 166 tumors. The observation period ranged from 6 to 193 months. Tumor growth control with an average follow-up period of 48 months (6—193) was 99%. The use of radiosurgery and hypofractionation for spinal hemangioblastoma, including associated with VHL syndrome, allows achieving high rates of relapse-free survival and tumor growth control with minimal toxicity, including with long-term follow-up. However, in the presence of a pronounced clinical picture, removal of GAB using a microsurgical approach remains the method of choice, since regression of existing symptoms rarely occurs after stereotactic radiotherapy. Increasing the total and single doses does not lead to improved results.