Selection of the prescription dose for arteriovenous malformation (AVM) radiosurgery is the final step in treatment planning. Physicians need to choose a prescription dose that provides an optimal middle ground between optimizing AVM obliteration with high radiation doses and limiting complication risks with the lowest doses. Accurately predicting complication risks for individual patients is a complex process that is highly dependent on the radiosurgery treatment volume, the target location and the nature of the target tissue. This article reviews the principles and data guiding dose selection for AVM radiosurgery.