Abstract: Radiotherapy(RT) improves the survival of many cancer patients, but there are some adverse effects of radiation. One of them is radiation-induced heart disease(RIHD). In case of chest irradiation, RIHD can affect the heart, blood vessels and lungs, with consequent tissue remodelation. This complex process is composed of a large number of interacting molecular signals, including cytokines, chemokines and growth factors. Inflammation, endothelial cell dysfunction, thrombogenesis, organ dysfunction and ultimate failing of the heart occur as the pathological entity-RIHD which is associated with radiation therapy for mediastinal lymphoma, breast, lung and oesophageal cancers, etc. And is the major source of morbidity and mortality. The long latent period is the reason why RHID is not extensively studied. With the prolonged survival of cancer patients, RIHD is growing concerned, especially in younger patients. In this review article, we discuss the pathogenesis, the type of injury and influencing factors.