<b><i>Background: </i></b>Brain metastases (BM) are an increasing challenge in modern oncology, as treatment options especially after exhaustion of local treatment approaches are very limited. <b><i>Patient and Methods: </i></b>A long-term surviving patient with brain-only metastatic breast cancer, who presented at our department with massive corticosteroid-refractory brain edema with serious neurological symptoms after exhaustion of all local therapy options, was started on bevacizumab. <b><i>Results: </i></b>Initiation of bevacizumab monotherapy led to rapid decrease of contrast-enhancing lesions and alleviation of brain edema, and allowed tapering and termination of corticosteroid administration. Neurological and neurocognitive function was restored and marked improvement in quality of life was observed. <b><i>Conclusion: </i></b>Our case highlights that bevacizumab may represent a feasible and effective salvage treatment option in selected patients with BM.