OBJECTIVE This study investigated the feasibility of using a large multi- leaf collimator (MLC) in a C-arm based linear accelerator for stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT). METHODS Patient Specific Quality Assurance was conducted on 69 patients treated with a single lesion SRS/SRT measuring dose distribution using patient-specific plans with SRS MapCHECK®. Statistics were used to analyze the significance of correlation among dosimetric parameters, included Conformity Index (CI), Gradient Index (GI), plan complexity, and Gamma passing rate (GPR) in an absolute dose (AD) and relative dose (RD). confidence limit (CL) was also calculated to evaluate the performance of a large multileaf collimator (MLC) in SRS/SRT. RESULTS Planning target volumes (PTVs) ranged between 0.34 cm3 and 30.42 cm3. The study found a value of CIICRU, CIPaddick, and GI of 1.29 ± 0.17, 0.77±0.10 and 5.24±2.18 (mean±SD), respectively, significant correlations were found between PTV sizes and dosimetric parameters. Values of GPR2%/2mm were 92.42±3.74 (AD), 96.38±3.24 (RD), whereas GPR2%/1mm were 82.03±6.69 (AD), 89.64±7.26 (RD). No significant correlation was found between plan co
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