In the past decade or more, few radiobiological quantities have received as much attention as the biological effectiveness (or RBE) of high-energy photons and electrons relative to conventional 200 to 300 kvp x-rays. Many of these studies have had a clinical rather than a radiobiological objective, namely the specification of the RBE for clinical therapy. No doubt it has often been felt that the effectiveness of a radiation measured, say, in the growth of broad bean roots or even in the survival of mice might have little bearing on its effectiveness as a therapeutic agent. In radiotherapy, the location and type of the lesion to be treated, the volume irradiated, the integral dose, the distribution of dose, the sparing of particular normal tissues, the dose fractionation technic, and many other factors in addition to RBE, must be involved in the choice of one type of radiation in preference to another. Nevertheless, the RBE is an important factor in guiding the thinking of the radiotherapist and in determining the dose protocol. It could be much more important if studies were to show a different RBE in tumor cells compared to normal cells. No such effect has been clearly established, and it must be emphasized that RBE per se does not imply any change in differential effect between the response of tumor and normal tissue. In radiobiology, these high-energy radiations are of limited interest in evaluating radiation mechanisms based on the variation of effectiveness with quality, because of the small range of RBE and LET (linear energy transfer) they encompass. Nevertheless, a number of features are of interest in RBE studies in this energy region, where dosimetry is now comparatively precise, which will be pointed out below. It will be our objective to review briefly some of the physical and biological considerations that enter into an RBE measurement in the high-energy region, to discuss many of the recently reported RBE studies, and to indicate some of the more interesting features. Concept of RBE The concept of RBE and the design of RBE determinations have been discussed elsewhere in detail (1, 2), and in the report of the RBE Subcommittee to the International Commissions on Radiological Protection and on Radiation Units (3). According to the ICRP definition, the RBE of a “test” radiation compared to a “standard” radiation is equal to Ds∕Dt, where Ds and Dt are the absorbed doses of the standard and test radiations, respectively, that produce the same effect in a particular biological system.