Objective: This review will focus on the late neurological complications from cranial irradiation and relevant mitigation strategies.Background: Radiotherapy (RT) remains an important pillar in the management of brain metastases.Patients being treated in the modern era do experience longer survival, because of superior intra-and extracranial disease control. As a result, they can be more prone to developing and manifesting late complications post-brain radiotherapy.Methods: A search and narrative review of prospective clinical trials relating to neurological toxicity outcomes was conducted.Conclusions: Neurological toxicities can be challenging to diagnose and manage and should be considered during consideration of radiotherapy in brain metastasis, hence more emphasis should be placed on prevention and upfront mitigation of these complications, with novel strategies showing promising results in prospective trials being adopted into clinical practice.