BACKGROUND There are several palliative treatment choices in patients with brain metastasis. Radiotherapy is one of palliative treatment modality in brain metastasis. The role of radiotherapy in metastatic brain disease has already been established. Patients with metastatic brain disease also treated conservatively. Sole conservative treatment were also done in regarding qualification of patient. This study aimed to compare radiotherapy and conservative treatment in one-year survival on brain metastasis patients. MATERIAL AND METHODS This study was a retrospective cohort study. The data acquired from Dept. of Neurology Cipto Mangunkusumo General Hospital between 2014–2016. Subjects with metastatic brain disease underwent radiotherapy and conservative treatment were included in this study. Sex, age, marital status, survival time, were retrieved from the subjects. The follow-up period were 1 year. Univariate analysis were done using t-test and chi-square test. Multivariate analysis were done using Log-rank test and Cox regression. RESULTS There were 41 subjects included in the study. Of 41 subjects, 21 (51.2%) underwent radiotherapy. The mean age of subjects underwent radiotherapy were 53.3 (SD ±12.6) vs 43.1 (SD ±14.7) in subjects with conservative management (P = 0.022). Women accounted for 27 out of 41 (65.9%) subjects. Married subjects accounted for 32 out of 41 (78%) subjects. There were no significance difference of treatment choices between married and unmarried subjects (P = 0.130). At the end of follow-up period, only 4 (19%) subjects from conservative treatment and 2 (10%) subjects from radiotherapy treatment survived (P = 0.854). Median survival of radiotherapy treatment were 5 month and 4 month in conservative treatment. Palliative treatment didn’t raise risk of death compared to conservative treatment [Hazard Ratio (HR) 0.94, 95% Confidence Interval (CI): 0.48–1.85, P = 0.867). CONCLUSION Radiotherapy treatment didn’t increase one-year survival in patients with metastatic brain disease. Other confounding factors that influenced survival should be included in further study to understand factors that interact with palliative treatment in brain metastases.