Background: The Novalis Certification Program is dedicated to providing a comprehensive and independent assessment of safety and quality in stereotactic radiosurgery (SRS). Methods: The program includes an independent review of SRS program structure, adequacy of personnel resources and training, appropriateness and use of technology, program quality management, patient-specific quality assurance and equipment quality control. Centres applying for Novalis Certification complete a self-study prior to a one-day visit by reviewers. Reviewers generate a descriptive 77-point report which is voted on by a multidisciplinary expert panel. Outcomes of reviews include mandatory requirements and optional recommendations, with the former requiring resolution prior to award of Certification. Sites undergo recertification every 4 years. Results: To date, 42 institutions have received Novalis Certification. A further 140 certification applications are pending. Two sites have been recertified, with 4 more in process this year. Analysis of review outcomes identified improved documentation of procedures as a frequent requirement, while frequent recommendations pertain to equipment/systems QA procedures and effective use of checklists/time outs. Conclusions: Novalis Certification is a unique, expanding peer review program assessing safety and quality in SRS and recognizing a high caliber of practice internationally. The standards-based approach highlights outstanding requirements and provides recommendations to enhance both new and established programs.