In patients with cardiac implantable electronic devices CIEDs, including cardiac pacemakers (PM) and implantable cardioverter-defibrillators (ICD), radiotherapy (RT) could compromise CIED function. Managing radiotherapy patients with CIED, has been a great practical and procedural challenge in radiotherapy and requires a structured multidisciplinary approach. A consensus document is presented as a result of a multidisciplinary working group involving cardiac electrophysiologists, Radiation Oncologists and Medical physicists. It aims to propose recommendations on risk stratification, management approach before, during and after radiation treatment/course of patients with CIED.