The objective was to analyze the radiotherapy (RT) practice at the cancer centre of a tertiary academicmedical institution in Delhi. This audit from an Indian public institution covered patient care processes relatedto cancer diagnosis, integration of RT with other anti-cancer modalities, waiting time, overall treatment time,and compliance with RT. Over a period of one year, all consecutively registered patients in radiotherapy wereanalyzed for the audit cycle. Analysis of 1,030 patients showed median age of 49.6 years, with presentation as stageI and II in 14.2%, stage III and IV in 71.2% and unknown stage in 14.6%. A total of 974 (95%) were advised forRT appointment; 669 (68.6%) for curative intent and 31.4% for palliation. Mean times for diagnostic workupand from registration at cancer centre to radiotherapy referral were 33 and 31 days respectively. Median waitingtime to start of RT course was 41 days. Overall RT compliance was 75% and overall duration for a curative RTcourse ranged from 50 days to 61 days. Non-completion and interruption of RT course were observed in 12%and 13% respectively. Radiotherapy machine burden in a public cancer hospital in India increases the waitingtime and 25% of advised patients do not comply with the prescribed treatment. Infrastructure, machine andmanpower constraints lead to more patients being treated on cobalt (74%) and by two-dimensional (78%)techniques.