Purpose/Objective: For the treatment of early-stage Hodgkin disease (HD), both the American College of Radiology Appropriateness Criteria Index and the National Comprehensive Cancer Network Practice Guidelines rate combined modality therapy (CMT) the most appropriate treatment approach, while giving chemotherapy (CT) alone the lowest consensus score. However, even in the presence of these guidelines, considerable heterogeneity exists in the treatment for early-stage HD. In this study, we sought to determine the concordance of treatment recommendations by practicing oncologists for early-stage HD with the existing guidelines and to analyze the variation in practice patterns among physicians. We also explored factors that influence a physician’s thought process and bias in rendering a treatment recommendation for this patient population.