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ABSTRACT Background: Radiotherapy in Nigeria has evolved over the years with new radiotherapy centres, and recorded success of radiation therapy. However, there are still challenges faced in this field. From insufficient infrastructure to workforce shortage, there is a need to have an outlook of the status quo and explore the way forward. Purpose: This paper intends to provide an outlook on radiotherapy, current challenges and possible solutions by reviewing relevant literatures available on the subject and providing recommendations. Method: The narrative review synthesized published literature and institutional reports on radiotherapy services in Nigeria. Search was done in Google Scholar, Pubmed, DOAJ. The search terms combined “radiotherapy” OR “radiation therapy” with “Nigeria” and with “challenges” OR “barriers” OR “workforce” OR “solutions” OR “financing”. Grey literature, including reports from the International Atomic Energy Agency (IAEA), the World Health Organization (WHO) and the International Agency for Research on Cancer (IARC), was identified through web searches and organizational websites. Results: There is a substantive gap in the practice of radiotherapy as compared with international recommended standards. The current outlook informs us that Nigeria has come a long way in radiotherapy services over the years. However, there is more to do. Conclusion: Urgent, intentional efforts must be put in place to address the underinvestment of radiotherapy in Nigeria. The author believes the solutions and recommendations are feasible if powered by political will, proper investments and necessary collaborations, locally and internationally. This outlook will be of relevance to policy makers, investors, healthcare establishments, healthcare workers and researchers. Keywords: Radiotherapy, Services, Cancer, Care, Challenges, Nigeria.