Background: Brain metastases represent a significant oncological challenge, adversely impacting survival and quality of life. This study aims to assess the one-year overall survival of patients with brain metastases following palliative radiotherapy, focusing on the influence of demographic and clinical factors. Methods: This prospective observational study enrolled 100 patients with brain metastases treated at Oncology Centers in Erbil, Iraq, from November 2022 to November 2023. Survival outcomes were analyzed in relation to primary cancer type, age, gender, number of brain metastases, and response to radiotherapy. Statistical analyses were conducted using SPSS version 28, with significance set at p ≤ 0.05. Results: The cohort had a mean age of 55.7 years, with a predominance of female (61%) patients. Breast cancer (42%) and NSCLC (33%) were the most common primary cancers. One-year survival was 36%, with younger age and surgical intervention for metastases significantly associated with improved survival. The response to radiotherapy also correlated with better outcomes. No significant association was found between survival and tumor grade, stage at diagnosis, presence of extracranial metastases, or performance status. Conclusions: The study highlights the significant impact of patient age, surgical treatment of metastases, and response to radiotherapy on the survival of patients with brain metastases. These findings underscore the necessity for early detection and tailored treatment strategies. The limitations of this study, including its sample size and observational design, suggest a need for further research in diverse populations and across multiple centers.