Peyronie's disease is a disabling condition, the treatment of which remains controversial. We evaluated 40 patients who underwent external beam radiation therapy for the treatment of chronic Peyronie's disease. While patients with penile plaque, penile curvature and impotence were treated little improvement was noted. Patients with penile pain or pain on erection responded well to radiation with rapid resolution of the pain. We conclude that external beam radiation therapy has only limited application in patients with Peyronie's disease. Patients with primary symptoms of penile pain or pain with erection may be improved through the use of external beam radiation therapy.