Pelvic radiation is commonly used for management of genitourinary and lower gastrointestinal malignancies. Radiation induced damage to rectum can present as acute radiation proctitis or chronic radiation proctitis (CRP), which presents months later. In India, cancer cervix is second common cancer in women (after breast cancer) and globally one fourth of cases are in India only. Radiotherapy is primary modality of treatment in early stage. Rectal complications are quite common in these cases. Therefore, incidences of chronic radiation proctitis are common in India. Pain, irregular bowel, and most importantly bleeding leading to anemia – these make quality of life very poor for these patients. Diagnosis is confirmed by endoscopy. Clinical and endoscopic findings determine grade of disease. Management of CRP is not standardized. Endoscopic, non-endoscopic and surgical modalities have a role in management of this condition. The management options vary depending upon the severity of the disease, complications and co-morbidities of the patient. Drugs are needed for pain, irregular bowel, and anemia. But most common distressing complain of rectal bleeding needs further intervention like topical sucralfate enema, formalin instillation or endoscopic intervention with argon plasma coagulation (APC), laser, heater probes or radio- frequency (RFA). Surgery in form of diversion, resection or reconstruction is reserved for cases of CRP presenting with complications like stenosis, severe bleeding, incontinence, or fistulas. This review gives an over-view of diagnostic criteria, prognostic scoring, and treatment algorithm for this common disabling condition, keeping in mind, cost and expertise available in our country.