Brain metastases are relatively common in anaplastic lymphoma kinase （ALK）-positive non-small cell lung cancer （NSCLC） patients. Although first-to third-generation ALK-tyrosine kinase inhibitors （TKI） have been widely used in the treatment of ALK-positive patients with brain metastases， some patients still experience inadequate intracranial control. First-generation ALK-TKI cannot penetrate the blood-brain barrier， and the addition of brain radiotherapy significantly improves intracranial control. In contrast， second- and third-generation ALK-TKI can cross the blood-brain barrier， offering better intracranial control. However， the beneficiary population and optimal timing for combining radiotherapy remain controversial. The optimal approach for combining ALK-TKI with cranial radiotherapy remains inconclusive. It should be determined by comprehensively considering factors such as prior radiotherapy history， the type of targeted drugs， the number of brain metastases， the interval time of ALK-TKI， and others. Close monitoring for radiotherapy-related adverse effects， such as brain necrosis， is also essential.