Accuray Incorporated Euan S Thomson Ph D President

Accuray Incorporated Euan S. Thomson, Ph. D. President and CEO September, 2010

2 D vs. 3 D Workspace Accuray Confidential 2 XXXXX. A

2 D vs. 3 D Workspace Accuray Confidential 3 XXXXX. A

2 D vs. 3 D Workspace Accuray Confidential 4 XXXXX. A

2 D vs. 3 D Workspace Accuray Confidential 5 XXXXX. A

2 D vs. 3 D Workspace Accuray Confidential 6 XXXXX. A

2 D vs. 3 D Workspace Accuray Confidential 7 XXXXX. A

Patient Population Hybrid RT vs. Cyber. Knife® & Cyber. Knife® VSI™ CONVENTIONAL RT RADIOSURGERY Early stage lung Early stage prostate Primary liver & mets Pancreas Spinestage lung Early re-irradiation Spinestage (curative) Early mets prostate Brain mets/primary Primary liver & mets Pancreas Spine re-irradiation Spine mets (curative) Brain mets/primary Breast Prostate Lymphoma Head and Neck Wide field RT US Market Opportunity* Accuray Confidential 8 XXXXX. A

Patient Population Hybrid RT vs. Cyber. Knife® & Cyber. Knife® VSI™ CONVENTIONAL RT RADIOSURGERY Large Field RT Precision IMRT Late stage breast Late stage prostate Late stage lung Lymphoma Head and Neck Whole Brain Early stage breast Early stage prostate Spine (Palliative) Head and Neck Peripheral lung Brain mets/primary Spine (curative) Pancreas Precision IMRT 362, 000 pts/year Radiosurgery 247, 000 pts/year US Market Opportunity* Accuray Confidential Radiosurgery 9 High Precision Radiosurgery Central/Apical lung Chest wall lung Early stage prostate Primary liver & mets Kidney Trigeminal Neuralgia AVMs Oligometases High Precision RS 643, 000 pts/year XXXXX. A

Patient Population Hybrid RT vs. Cyber. Knife® & Cyber. Knife® VSI™ Cyber. Knife® CONVENTIONAL RT Large Field RT Precision IMRT Late stage breast Late stage prostate Late stage lung Lymphoma Head and Neck Whole Brain RADIOSURGERY Radiosurgery Early stage breast Early stage prostate Spine (Palliative) Head and Neck Peripheral lung Brain mets/primary Spine (curative) Pancreas Radiosurgery 247, 000 pts/year US Market Opportunity* Accuray Confidential High Precision Radiosurgery Central/Apical lung Chest wall lung Early stage prostate Primary liver & mets Kidney Trigeminal Neuralgia AVMs Oligometases High Precision RS 643, 000 pts/year Cyber. Knife® 890, 000 pts/year 10 XXXXX. A

Patient Population Hybrid RT vs. Cyber. Knife® & Cyber. Knife® VSI™ Hybrid RT Systems CONVENTIONAL RT RADIOSURGERY Large Field RT Precision IMRT Late stage breast Late stage prostate Late stage lung Lymphoma Head and Neck Whole Brain Radiosurgery Early stage breast Early stage prostate Spine (Palliative) Head and Neck Peripheral lung Brain mets/primary Spine (curative) Pancreas Accuray Confidential Central/Apical lung Chest wall lung Early stage prostate Primary liver & mets Kidney Trigeminal Neuralgia AVMs Oligometases Radiosurgery 247, 000 pts/year Precision IMRT 362, 000 pts/year US Market Opportunity* High Precision Radiosurgery Hybrid RT 609, 000 pts/year 11 XXXXX. A

Patient Population Hybrid RT vs. Cyber. Knife® & Cyber. Knife® VSI™ CONVENTIONAL RT RADIOSURGERY Large Field RT Precision IMRT Radiosurgery Late stage breast Late stage prostate Late stage lung Lymphoma Head and Neck Whole Brain Early stage breast Early stage prostate Spine (Palliative) Head and Neck Peripheral lung Brain mets/primary Spine (curative) Pancreas High Precision Radiosurgery Central/Apical lung Chest wall lung Early stage prostate Primary liver & mets Kidney Trigeminal Neuralgia AVMs Oligometases Cyber. Knife® (100%) 890, 000 pts/year Hybrid (28%) 247, 000 pts/year Accuray Confidential 12 CK RS patients ~3. 6 x Hybrid XXXXX. A

2007 – 2008 Medicare Reimbursements 2007 120 2008 112 103 105 90 CK RS patients ~3. 6 x Hybrid 75 61 60 71 64 CK RS patients ~3. 6 x Hybrid 61 45 30 18 16 15 0 Sites Reporting Medicare 1 st Fractions Average Medicare Patients Per Site Cyber. Knife® Trilogy/Novalis Accuray Confidential 13 XXXXX. A

Top 20 Sites (Medicare) FACILITY CITY, STATE SYSTEM 2008 1 Winthrop University Nassau, NY Cyber. Knife 195 2 UPMC Presbyterian Pittsburgh, PA Cyber. Knife 176 3 Georgetown University Hospital Washington, DC Cyber. Knife 176 4 Stanford Hospital & Clinics Palo Alto, Ca Cyber. Knife 173 5 Via Christi Regional Medical Center Wichita, KS Cyber. Knife 144 6 Memorial Hospital Jacksonville, FL Cyber. Knife 133 7 Bristol Regional Medical Center Kingsport/Bristol, TN Cyber. Knife 127 8 Methodist Hospital San Antonio, TX Cyber. Knife 119 9 Harris Methodist Fort Worth, TX Cyber. Knife 101 10 St Catherine Hospital Gary, IN Cyber. Knife 98 11 Well. Star Kennestone Marietta, GA Cyber. Knife 92 12 Memorial Sloan Kettering Cancer Center New York, NY Trilogy/Novalis 91 14 Delaware County Memorial Hospital Philadelphia, PA Cyber. Knife 89 15 Christiana Healthcare Wilmington, DE Cyber. Knife 89 16 Carolinas Medical Center Charlotte, NC Cyber. Knife 86 17 North Florida Regional Medical Center Gainesville, FL Cyber. Knife 84 18 Lafayette General Medical Center Lafayette, LA Cyber. Knife 84 19 Central Baptist Hospital Lexington, KY Cyber. Knife 84 20 Beth Israel Deaconess Medical Center Boston, MA Cyber. Knife 82 18 of Top 20 Sites/Medicare SRS/SRT Claims are Cyber. Knife Sites 13 Dartmouth Hitchcock Medical Center Pittsburgh, PA Trilogy/Novalis 90 Accuray Confidential 14 XXXXX. A

Corporate Development Accuray Confidential 15

Accuray/Siemens Strategic Alliance Main Points § Announced June 9, 2010 § Expanded global sales opportunities for Cyber. Knife § Global sales as part of multi system purchases § Address under or un-served markets § Complementary sales effort § Purchase of selected technology § Accuray to produce and sell certain technology solutions to Siemens to enhance its radiation therapy product line § Research & development alliance § Gives Accuray potential access to state of the art imaging technologies Accuray Confidential 16

Corporate Development Worldwide Sales Coverage Accuray Sales Coverage Distributors Coverage Sales coverage in over 80 countries worldwide Accuray Confidential 17 As of July 2007

Corporate Development Worldwide Cyber. Knife Installed Base ® EUROPE 29 Installed APAC AMERICAS 132 Installed 24 Installed JAPAN 21 Installed June 30, 2010: 206 Cyber. Knife Systems Installed Worldwide ® Accuray Confidential 18

FY’ 10 Actual: New Orders and Shipments Q 4 Q 3 Q 2 Q 1 TOTAL ORDERS 16 14 18 9 57 SHIPMENTS 13 8 12 6 39 FY’ 10 Book to Bill Ratio was 1. 46 (approximately 50% growth) Accuray Confidential 19 XXXXX. A

Financial Update Accuray Confidential 20

Backlog Segmentation Shared Ownership $16 M (4%) Cyber. Knife® Services $132 M (35%) $226 M (61%) Total Backlog $374 M (100%) Unaudited As of June 30, 2010 Accuray Confidential 21

Revenue Growth Products and Services Platinum (Legacy Revenue) Bulk Shared Ownership Sale To 3 rd Party Preliminary Guidance given August 31, 2010 $5 $60 $29 $34 Revenue $M $193 $24 $11 $129 $152 $174 11% 15% 18% Product Service Accuray Confidential Service 22 Service 14% 6% $15 guidance range $205

Financial Summary Growing revenue (current products & service) 11% for FY 2010 | 6% to 14% for FY 2011 (guidance*) Strong balance sheet $145. 3 M** in cash & investments No debt *guidance given 8/31/10 Accuray Confidential 23

Accuray Incorporated Euan S. Thomson, Ph. D. President and CEO September, 2010