Purpose: To review on outcomes of Phosphorus-32 (32P) intracavitary irradiation for Craniopharyngiomas.Methods: A literature review of all full publications in English biomedical journals (1981-2014) was performed. The search strategy included a combination of key words “phosphorus-32”, “craniopharyngioma”, “intracystic treatment”, “brain”, “cyst”, “tumor”, “brachytherapy”, “intracavitary irradiation”, “isotope” in the title and abstract of the manuscripts using the PubMed. The major findings were summarized, with a focus on outcome as visual acuity, complications, cyst volume, and irradiation dose delivered to the cyst wall in Gy. Finally, the future of 32P intracavitary irradiation for Craniopharyngiomas was explored.Results: A total of 25 citations were identified and screened. In all, 19 citations were eligible for inclusion. The synthesis of the data showed several benefits and adverse events for 32P intracavitary. Overall benefits included improvements in visual, endocrinological, and neurological outcomes, while adverse effects included complications such as III palsy and diabetes insipidus.Conclusion: In general 32P intracavitary irradiation was found to be a reasonable option in treatment of highly selected patients with newly diagnosed or recurrent cystic craniopharyngioma. This approach can be expected to overcome some limitations introduced by other approaches with a relatively low complication rates