To evaluate the acute adverse effects and early cosmetic outcomes of patients treated with electronic brachytherapy for the treatment of cutaneous malignancies. From July 2009 till March 2010, 34 patients with 40 cutaneous malignancies were treated with Xoft Axxent Electronic Brachytherapy system using surface applicators to a dose of 40.0 Gy in 8 fractions, 5 Gy per fraction, delivered twice weekly with minimum of 48 hour interval. The appropriately sized surface applicator, 10mm, 20mm, 35mm, or 50mm, was selected to allow for complete coverage of target lesion with acceptable margin. CT scan was performed to assess skin depth. The prescription depth was 3-7mm, 5mm for 83% of the lesions, 3mm for 15% of the fractions, and 7mm for the patient with T-cell lymphoma. All patients were treated outside of a linear accelerator vault in CT simulator room. Photographs were taken for all patients at initial consultation and follow-up visits. Acute safety outcomes and cosmetic results were analyzed. Cosmetic results were documented in the patient record using a standardized cosmesis scale. There were 34 T1 lesions and 6 T2 lesions; 38 were primary cancers, and 2 were recurrences. 26 skin lesions were basal cell carcinoma, 12 were squamous cell carcinoma, 1 was Merkle cell carcinoma, and 1 was T-cell lymphoma. 17 lesions were located on the nose, 5 on the ear, 10 on the face, 4 on the scalp, and 4 on the extremities. Median follow-up was 3.2 months (range, 1-7.3). Average treatment time was 6.8 minutes per fraction. 91% developed radiation dermatitis grade 1 or 2 during treatment and resolved by the 1 month, 3 month or 6 month visit. There were no severe (Grade 3 or higher) acute toxicities. 1 patient developed moist desquamation during treatment which resolved at 1-month follow-up. One patient developed hypopigmentation at 3 months, and 3 patients developed hypopigmentation at 6 months. Cosmetic assessments of the treated areas done at various intervals from the last fraction are grouped for reporting: 25 were assessed at 1 month, 17 at 3 months, 8 at 6 months, and 1 at 7 months. The cosmetic results showed 88.0%, 94.1% 71.4%, 100.0% excellent at 1, 3, 6 and 7 months respectively and 12%, 5.9%, and 28.6% showed good results at 1, 3, and 6 months respectively. There was no evidence of tumor recurrence for all lesions. The early outcomes of electronic brachytherapy for the treatment of non-melanomatous cutaneous malignancies appear to show acceptable acute toxicities and favorable early cosmesis. The early results seem comparable to High Dose Rate Brachytherapy. The hypofractionated approach provides patient convenience approach with effective early outcomes. Long-term follow-up is being collected to further assess efficacy and cosmesis.