Brachytherapy is an essential component of the curative treatment of cervical cancer, a disease with high incidence in many developing countries The IAEA supports the use of high dose rate brachytherapy for centres with a large number of patients with this disease. HDR brachytherapy is also used in other common cancers such as breast cancer, lung, oesophagus and prostate. This publication provides guidance to radiation oncologists, medical physicists and planners on establishing and operating a high dose rate brachytherapy unit with modern standards and presents the main issues to be addressed for its effective and safe operation.