<h3>Purpose/Objective(s)</h3> The objective of this study is to determine how the epigenome is locally altered after DNA damage and investigate the impact of these changes on 3D chromatin organization, gene regulation and treatment resistance. In glioblastoma, treatment with radiation and chemotherapy leads to DNA-damage and most DNA breaks are faithfully repaired, but the impact on the epigenome is largely unknown. Since epigenetic alterations such as DNA-methylation can impact the binding of factors involved in chromatin folding, and transcription factors that bind regulatory elements, the downstream impact on gene regulation could lead to the emergence of treatment resistance. Using newly developed tools to enable these studies, we hypothesize that genome-wide DNA damage leads to local alterations in DNA-methylation, genome organization, and results in persistent gene-expression alterations near sites of repaired damage. <h3>Materials/Methods</h3> We use patient-derived human glioblastoma stem-like cells (GSCs) as a model. DNA breaks are induced using (i) irradiation or (ii) a novel "multi-cut" CRISPR-Cas9 DNA break system. Genomic profiling methods include HiC (genome-wide chromosome conformation capture), DNA-methylation profiling (bisulfite sequencing), targeting DNA-seq and RNA-seq. <h3>Results</h3> With radiation, we find significant and wide-spread alterations in DNA-methylation after treating multiple glioblastoma cultures. It is difficult to study local alterations around sites of radiation induced damage because breaks are introduced at different sites in each cell, resulting in stochastic DNA methylation alterations. To circumvent this issue, we developed a multi-cut CRISPR-Cas9 DNA break system that targets 142 or 483 pre-defined loci. Induction of pre-mapped genome-wide cuts reproduces a similar level of toxicity as standard doses of radiation. To assess repair efficiency (i.e., deletions, translocations), we employed a custom panel of DNA probes that flank the 142 or 483 sites to allow for high coverage sequencing at each site following cut induction. To understand how DNA damage may lead to local epigenetic alterations and 3D chromatin organization changes, we performed HiC (genome-wide chromosome conformation capture), before and after cut induction, and subjected cultures to further downstream analysis. Our findings show significant mega-base scale alterations in chromatin contacts centered around cut sites, enrichment of DNA methylation alterations and altered gene-expression. <h3>Conclusion</h3> The multi-cut CRISPR-Cas9 DNA break system, which we develop and characterize here, can be rapidly employed in cell lines or animal models to study pre-mapped genome-wide DNA damage, and has widespread applicability in the radiobiology and DNA damage and repair fields. The findings here provide a mechanistic view of the interplay between genome-wide DNA damage, DNA methylation and genome re-organization, and have wide-ranging implications for the effect of DNA damage on the epigenome.