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Chapter 15 covers gynaecological cancers, including, uterine, cervical, and vaginal and vulval cancers. Ovarian cancer has not been included, as radiotherapy has only a limited role in its management. MRI is the preferred imaging modality for local staging and follow-up of uterine, cervical, and vaginal cancers due to its superior tissue contrast and delineation of anatomy and pathology. The use of intravenous gadolinium and diffusion weighted imaging provides more accurate characterization of the tumour. Contrast enhanced CT is used for assessment of distant metastasis and FDG PET/CT has a role in selected cases. Most vulval cancers are treated surgically with initial clinical assessment of the primary tumour, but for more advanced cases, MRI can help assess tumour extent and involvement of regional nodes.