Chart Rounds represents an important quality assurance institution which focuses on physician and physicist peer review. Its use is ubiquitous in the field of radiation oncology and successful implementation is a requirement for accreditation by established governing bodies. Despite its importance, there is scant literature which identifies time spent on each chart review. This study provides an examination of time spent in this endeavor and explores factors that influence the length thereof at a busy hospital practice. In October, 2015, we employed an electronic medical record (EMR) with automated triggered events based on scheduling of patient treatment. Based on the initiation and completion of an event, a time stamp is generated in the EMR. We analyzed time stamps that focused on the initiation and completion of an event associated with the review of individual patient treatments at Chart Rounds. During these weekly meetings, review focuses on consultation notes, dose constraint sheets, prescriptions, treatment plans, and, when applicable, port film review. From January 8, 2016 to December 30, 2016 1199 consecutive patient charts were reviewed at weekly chart rounds. 83.3% of cases involved definitive treatment vs. 16.7% involving palliative radiation. 52.5% of reviewed cases involved the use of stereotactic techniques; 26.5%, 14.1%, and 5.7% involved 3DCRT, hand calculations (calcs), and IMRT, respectively. 127 (10.6%) of the presentations involved a subsequent treatment course for a previously reviewed patient. The mean time per patient presentation was 142.6 seconds (s). Discussions relating to 3DCRT (209.6s) and IMRT (204.5s) were longer on average than those involving Stereotactic treatment (104.2s) and hand calcs (136.8s; p<.0001). More time was spent reviewing patients presented for the first time than for subsequent courses of treatment (mean 147.5s vs. 100.9s, p=.017). Significant variation existed based on disease site, with roughly twice the time spent for head and neck (243.3s) compared to genitourinary malignancy (112.1s; p<.0001). On univariate analysis, predictors of spending at least 150s on discussion included cases involving head and neck malignancy (66.7% vs. 12.2% for genitourinary; p<.0001), age younger than 60 (27.9% vs. 12.2% for older patients; p=.003), and first course of treatment (22.9% compared to 1.2% for subsequent treatment; p=.002). On multivariate analysis, patient age <60 (OR 1.63, CI 1.08, 2.44, p=.019), first treatment course (OR 2.75, CI 1.16, 6.54, p=.021), and reviewing IMRT treatment (OR 2.474, CI 1.099, 5.568, p=.029) predicted for spending at least 150s per case. Time spent reviewing each patient’s treatment at chart rounds can be measured, and predictors of lengthier discussion characterized. Identification of these factors might facilitate an awareness of cases that might warrant a slower or more deliberate review for quality assurance.