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Sara Chierchini,1 Gianluca Ingrosso,1 Simonetta Saldi,1 Fabrizio Stracci,2 Cynthia Aristei1 1Radiation Oncology Section, Department of Surgical and Biomedical Sciences, University of Perugia and Perugia General Hospital, Perugia, Italy; 2Department of Experimental Medicine, Section of Public Health, University of Perugia, Perugia, ItalyCorrespondence: Gianluca IngrossoDepartment of Surgical and Biomedical Sciences, University of Perugia, Piazza Lucio Severi 1, Perugia 06132, ItalyTel +39-075-5783259Fax +39-075-5783614Email ingrosso.gianluca@gmail.comAbstract: Radiotherapy is one of the mainstays of cancer treatment, and about 60% of cancer patients receive this type of treatment during their course of treatment. An evident gap between optimal and actual radiotherapy utilization proportions has recently been reported, which has been ascribed to lack of referral to radiation oncology. There are many factors influencing the radiotherapy referral, including patient anxiety about toxicity, wrong perception of efficacy and side effects by physicians and patients, insufficient knowledge of referral process. These factors, defined as barriers can be categorized in health system barriers, physician and patient barriers. In the present brief narrative review, we discussed barriers to radiotherapy referral focusing on physician and patient barriers.Keywords: radiotherapy, referral, barriers