Radiation therapy is a critical component of the multidisciplinary management of gynecologic cancers. In certain organ sites like advanced cervix and vulva/vaginal cancers, it is the primary therapeutic modality and can control tumors while preserving form and function of the affected area. Yet more precise surgical techniques and newer chemotherapeutic and biologic agents have questioned the role of radiation, particularly in light of some of the chronic toxicity it can cause. This chapter highlights the current controversies in the multimodality management of gynecologic cancers. Newer radiation delivery techniques and updated roles for radiation are described for all the subsites of this group in the context of surgical and medical management for these cancers.