Pivotal clinical trials (KEYNOTE-001) have demonstrated improved survival in non-small cell lung cancer (NSCLC) patients treated with both radiotherapy (RT) and immunotherapy (IO). The purpose of this study was to document response rates and survival in patients receiving both RT and IO in routine clinical practice. All metastatic NSCLC patients treated with Nivolumab or Pembrolizumab between 11/2015 and 10/2017 in one Canadian province were identified. Demographic, tumor, treatment, toxicity, and response data were collected. Fisher’s Exact Test and Chi Squared Test were used to assess the relationship between treatment characteristics and outcome. Log Rank Test and Cox Regression were used to assess overall survival (OS) and progression free survival (PFS). 271 patients treated with IO were identified of which 202 were treated with previous RT (75%) including 153 treated with chest radiotherapy. Median follow up from initiation of IO was 30.3 (0.3-139.9) weeks. At time of last follow up, 56% of patients had died. There were no statistically significant differences in physician assessed response rates in patients treated with prior radiotherapy (52 vs 58%, p=0.41) or prior chest radiotherapy (52% vs 55%, p=0.71). Median PFS was 11 weeks in patients who received RT and 13.9 weeks in patients who did not (p=0.73). Median OS was 41.3 weeks in the radiotherapy cohort versus 42.9 weeks (p=0.50). On univariate analysis, ECOG (p<0.001) and CCI (p<0.001) were associated with OS while prior chest radiotherapy, prior curative radiotherapy, brain metastases, type of IO, squamous histology, smoking status and age did not. There were no statistically significant differences in response rates, PFS or OS in patients receiving IO for mNSCLC treated with or without prior RT.