•Radical trachelectomy is a fertility sparing option for select stage I cervical patients.•Indications for adjuvant treatment following trachelectomy are based on standard recommendations following hysterectomy.•Case report outlining specifics of imaged-guided brachytherapy as part of the adjuvant treatment after trachelectomy.
Keywords: Cervical brachytherapy; Cervical cancer; Fertility preservation; Pelvic radiation; Trachelectomy.