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Penile cancer is rare. Thus, there are no therapeutic recommendations fulfilling the requirements of evidence-based medicine. The empirically based therapeutic approach consists of local excision, laser therapy, or radiotherapy with comparable local control rates. Radiation is delivered by external beam radiotherapy or as brachytherapy. After radiotherapy, 5-year survival rates of 66-92% and organ preservation in 55-84% are reported. Serious long-term sequelae are necrosis (3-23%) and urethral stenosis (6-45%) requiring surgery. In the adjuvant treatment of the locoregional lymph nodes, lymphadenectomy and radiotherapy of both inguinal regions are therapeutic options. Inguinal lymph node metastases may be irradiated pre- or postoperatively to reduce the local recurrence rates. In addition, palliative radiotherapy of the primary tumor, lymph node, or distant metastases is of use for incurable patients. New combined therapies, e.g., radiochemothermotherapy, are currently under clinical evaluation and may offer a curative and organ-preserving therapeutic option to patients with locally advanced tumors.