Background: To study the pattern of patient load, personnel and equipment resources from 30-yearsexperience in Southern Thailand. Materials and Methods: This retrospective study collected secondary datafrom the Division of Therapeutic Radiology and Oncology and the Songklanagarind Hospital Tumor Registrydatabase, Faculty of Medicine, Prince of Songkla University, during the period of 1982-2012. Results: The numberof new patients who had radiation treatment gradually increased from 121 in 1982 to 2,178 in 2011. Shortagesof all kinds of personnel were demonstrated as compared to the recommendations, especially in radiotherapytechnicians. In 2011, Southern Thailand, with two radiotherapy centers, had 0.44 megavoltage radiotherapymachines (cobalt or linear accelerator) per million of population. This number is suboptimal, but could bemanaged cost-effectively by prolonging machine operating times during personnel shortages. Conclusions: Thisstudy identified a discrepancy between workload and resources in one medical school radiotherapy center inSouthern Thailand. This information is crucial for future strategic planning both regionally and nationally.