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This single-institution retrospective study reviewed outcomes in 63 patients who underwent surgery for brain metastases, comparing those who received carmustine (BCNU) wafers at the time of resection to those who did not. Lung cancer was the most common primary cancer in the cohort. Progression-free survival (PFS) was significantly improved in the BCNU group versus the surgery-only group. Median overall survival from the time of surgery was 10 months with BCNU versus 7 months without, a difference that did not reach statistical significance. This is the largest modern, two-arm study of BCNU wafers in brain metastases, and it supports their potential to improve local control when used alongside surgery.