Radiation medicine has progressed from a volume and anatomical landmark-guided approach to an image-and function-guided therapy. It takes into account possible routes of tumour spread, biologically active tumour volumes and critical normal structures lying in or near target volumes with a focus on delivering maximal tumoricidal doses while sparing the surrounding normal structures. Radiation oncology has advanced rapidly with introduction of better diagnostic tools, immobilization methods and treatment machines. Now, instead of treating large regional volumes, the field is fashioned and the dose is sculpted depending on the tumour volume, location and activity. Newer imaging modalities enable near-and real-time tracking of tumour even during delivery of radiation.