Treatment of cancer patient need a multidisciplinary approach. Radiation therapy is a main part of this strategy. Curative radiotherapy is routinely delivered over multiple, small daily fractions. Palliative radiotherapy (PRT) require lower total doses, focusing to symptom control with shorter courses of larger fraction size (hypo-fractionation). PRT is aiming of to reduce symptoms of from the primary tumour or from metastatic deposits. It is suitable for 50 % of cancer patients in Africa. We review the techniques, benefits, and side effects of this palliative treatment. PRT provides pain relief in a median of 2-3 weeks for 60% of patients with bone metastasis. It improved obstructive dysphagia in two thirds of patients. Urgent PRT (within 24 hours) reduces pain and improve neurological function of malignant spinal cord compression. For patients with limited brain metastases and a life expectancy of more than six months, stereotactic radiotherapy can be considered under discussion. For more extensive cerebral disease, whole brain radiotherapy can be offered. More than 70 % of head and neck with pain, dysphagia or odynophagia, airway compromise, bleeding, and tumour bulk, will benefit from PRT. It palliated bleeding in up to 90% of patients with advanced bladder, rectal, or gynaecological cancer and improved other symptoms for half to two thirds of patients. Skin cancers responded to palliative radiotherapy in 60% of cases with control of Bleeding, pain, and malodour due to advanced primary tumor. In conclusion PRT is cost effective and useful treatment for most of advanced cases of cancer.