Every year 40% of Americans who are diagnosed with primary cancer will go on to develop metastatic brain cancer. Current treatment of metastatic brain cancer involves a multidisciplinary approach, with involvement from surgery and radiotherapy. The available treatment options can thus be overwhelming and conflicting. This chapter focuses on the current consensus in the literature concerning the role of chemotherapy in treating metastatic brain cancer. The existing evidence suggests that chemotherapy is not a viable option as the sole treatment for metastatic brain cancer.