Metastasis to the skull–base particularly affects patients with carcinoma of the breast and prostate. Clinically, the key feature is progressive ipsilateral involvement of cranial nerves. Magnetic resonance imaging (MRI) is nowadays the most useful examination to establish the diagnosis but plain films, CT scans with bone windows and isotope bone scans remain helpful to demonstrate bone erosion. The treatment depends on the nature of the underlying tumor. Radiotherapy is generally the standard treatment. The overall prognosis is poor, with an overall median survival of about 2.5 years, probably because skull–base metastases appear late in the course of the disease.