Purpose of review This article evaluates the field of radiogenomics within recent developments in genomics and radiation biology. Recent findings Many pediatric cancer survivors have undergone treatment with radiation, putting them at risk for long-term side-effects associated with this therapy, especially cardiac disease and secondary malignancies. Advancements in our understanding of radiation biology have led to the understanding that genetics plays a major role in determining a patient's susceptibility to developing long-term side-effects, leading to the field of 'radiogenomics'. Although initial candidate gene studies did not demonstrate replicable genetic variants that affected radiosensitivity, genome-wide association studies have recently begun to identify genes that may help explain some of the observed variation in radiosensitivity. As genomic sciences continues to progress and whole genome studies become more accessible, our understanding of the genes responsible for radiosensitivity will continue to progress. Summary The field of radiogenomics continues to evolve with the availability and improved cost of genomic technologies allowing the study of an increasing fraction of the human genome. Studies into genetic factors influencing individual radiosensitivity will increase our understanding of radiobiology and improve our ability to counsel patients on the adverse effects they will likely experience.