The reported incidence of childhood cancer has increased in India over the last 25 years [1]. The five top childhood cancer sites are leukemia, lymphoma, central nervous system (CNS), bone, and retinoblastoma [2]. Radiotherapy has an important role to play in all these malignancies. Planning and treating children with radiotherapy requires an understanding of the differences between adult and pediatric cancers and the consequences of the treatment. Radiation therapy treatment planning is more challenging for children than for adults for many reasons. First, most of the childhood cancers are being treated curatively, while 30–50% of the adults are treated with palliative intent. Second, many tissues in children have a lower tolerance to radiation than adults. Modern radiation therapy practices are precise and require strict immobilization for accurate delivery, and this poses a unique challenge for the pediatric population vis-à-vis adults.