stereotactic body radiotherapy for oligometastasis opportunities for biology to guide clinical management oligometastasis refers to a state of limited metastatic disease burden in which surgical or ablative treatment to all known visible metastases holds promise to extend survival or even effect cure stereotactic body radiotherapy is a form of radiation treatment capable of delivering a high biologically effective dose of radiation in a highly conformal manner with a favorable toxicity profile enthusiasm for oligometastasis ablation however should be counterbalanced against the limited supporting evidence it remains unknown to what extent if any ablation influences survival or quality of life rising clinical equipoise necessitates the completion of randomized controlled trials to assess this several of which are underway however a lack of clear identification criteria or biomarkers to define the oligometastatic state hampers optimal patient selectionthis narrative review explores the evolutionary origins of oligometastasis the steps of the metastatic process at which oligometastases may arise and the biomolecular mediators of this state it discusses clinical outcomes with treatment of oligometastases ongoing trials and areas of basic and translational research that may lead to novel biomarkers these efforts should provide a clearer biomolecular definition of oligometastatic disease and aid in the accurate selection of patients for ablative therapies