Choroidal haemangiomas are rare, benign vascular tumours of the eye that may cause significant visual impairment due to exudative retinal detachment and macular oedema. While many cases remain asymptomatic, progressive lesions often require intervention. Radiation therapy (RT) has emerged as an effective treatment for symptomatic cases, particularly when conventional treatments fail or are contraindicated. With advancements in radiotherapy techniques like plaque brachytherapy and stereotactic radiosurgery, RT now offers high precision, minimal toxicity, and excellent functional outcomes. This chapter reviews the pathogenesis, indications, and outcomes of radiation therapy in managing choroidal haemangiomas, highlighting both its current role and future potential.