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Abstract Background: External beam radiotherapy (EBRT) is a key treatment for breast cancer, but acute side effects may reduce comfort, quality of life and treatment completion. Data from newly established radiotherapy centres in Nigeria are limited. Objective: To describe the acute side effects recorded during EBRT in breast cancer patients at the Department of Radiotherapy and Clinical Oncology, University of Benin Teaching Hospital (UBTH), Benin City, to describe the timing of symptom onset, and to explore the relationship of side effects with radiation dose and patient factors. Methods: This was a retrospective cross-sectional analysis of 85 coded patient records (April to September 2026) of adult women receiving EBRT. Age, breast treated, dose per fraction, total dose, recorded side effects and onset period were extracted. Data were summarized with frequencies, percentages, means, standard deviations and 95% Wilson confidence intervals, and analyzed with the chi-square test, Mann-Whitney U test, Kruskal-Wallis test and Spearman’s correlation (significance, p < 0.05). Results: The mean age was 50.69 ± 11.10 years (range, 30-70), and 52.9% had left-breast disease. The mean dose per fraction was 2.44 ± 0.40 Gy and the mean recorded total dose was 17.93 ± 2.06 Gy. Cough (27.1%), high blood pressure (25.9%), fatigue (23.5%) and arm swelling (23.5%) were most frequently recorded; 148 symptom occurrences were documented (mean, 1.74 per patient). Symptom onset was recorded during weeks 1-4 in 88.2% (peak in week 3, 27.1%) and after treatment in 11.8%. Total dose was not significantly associated with side-effect burden (rs = 0.120, p = 0.275) or onset category (rs = -0.123, p = 0.260), and laterality and age were not significantly associated with side-effect burden. An exploratory association between age group and cough (p = 0.031) was based on sparse cells. Conclusion: Acute symptoms were commonly documented during breast EBRT, mostly during weeks 1-4, but severity grades, stage, technique and fractions delivered were not recorded, which limits interpretation. Standardized toxicity grading and complete treatment documentation are recommended.