AIM: To evaluate the efficacy of ruthenium-106 plaque brachytherapy for the treatment of diffuse choroidal hemangioma (DCH) in Sturge-Weber syndrome (SWS). METHODS: A total of 8 patients with DCH in SWS managed with plaque brachytherapy were retrospectively included. Patients were treated with ruthenium-106 plaque therapy (median apex dose: 83 Gy) at the thickest tumor region. On follow-up, we recorded the tumor thickness, the best-corrected visual acuity (BCVA), subretinal fluid (SRF) status, and complications following treatment. RESULTS: At a median follow-up of 43mo, tumor regression was observed in all cases, with a complete resolution of SRF and reduction in tumor-thickness. No radiation complications were recorded during the follow up time. CONCLUSION: Ruthenium-106 plaque therapy to the thickest portion of the tumor seems to be a useful treatment in patients with DCH in SWS.