With rapid progress our field, innovations in radiation oncology are represented at the Annual Meeting and other conferences, and are widely published and implemented. However these advanced concepts and techniques are challenging to translate into environments with less manpower, technology and infrastructure. This course will address this challenges and the status of radiation oncology, manpower, access to care and treatment technologies in developing countries. It will examine the impact of and rapidly advancing methods/technologies on radiation oncology practice in developing countries, and examine pitfalls, particularly safety issues, of introducing advanced procedures and methods into these environments. The session will discuss strategies to bridge the knowledge and technology gap, so to apply modern radiation oncology concepts despite more limited equipment and infrastructure. New scientific/technological advances that are presented at ASTRO 2012 will be used as examples. Approaches to broaden educational opportunities and ways for radiation oncologists in both, developed and developing countries, to engage in the process will be discussed. This educational course is sponsored and organized by the ASTRO International Education Subcommittee. At the conclusion of this activity, the learner will be able to do the following: 1. Identify the gaps in technology in developing countries and its significance for patient care in large populations worldwide. 2. Describe ways to apply modern radiation oncology concepts and scientific findings despite more limited equipment and infrastructure. 3. Outline strategies for radiation oncologists to help close the gap in radiation oncology care.