Radiation therapy is often used to palliate symptoms caused by cancer. Short course, or “hypofractionated” palliative radiation therapy provides equivalent palliation in the setting of non-osseous metastasis or uncontrolled localized cancer while being more convenient and cost-effective than longer courses of radiation. Hypofractionated palliative radiation plays a role in the management of obstruction due to tumor, neurologic symptoms, pain caused by localized bulky disease, and bleeding in patients with primary tumors of the lung, head and neck, bladder, rectum, gynecologic malignancies, and metastasis to the liver, lung and brain. Hypofractionated palliative radiation is well tolerated with minimal and self-limited side effects. The side effects that do occur are generally limited to the body region treated and last from a few days to a few weeks.