<h3>Purpose/Objective(s)</h3> Skin cancers in less developed countries often present at advanced stages, and often with symptoms and in the elderly. Imaging resources are limited, advanced surgical techniques and plastic repair is often not available, and patients must bear much of the cost of treatment. Many patients are referred for radiation therapy (RT) for symptoms such as malodorous discharge, bleeding, or pain. This study is done to evaluate the results of evaluation and treatment in a country with limited resources, but with sophisticated radiation techniques. <h3>Materials/Methods</h3> 100 patients who completed definitive radiation therapy (96) or adjuvant RT for positive margins (4) between 2015 and 2022 were identified in the RT database. All were planned with a CT simulation. Lymph nodes (L/N) were evaluated by the sim CT +/- ultrasound and FNA, and treated if suspicious. RT doses ranged from 52-70 Gy with variable fraction sizes and schedules, with a planned EQD2 dose of 55-70 Gy. RT techniques included electrons or VMAT. For follow-up, patients or their family were contacted regarding medical status, symptom response, tumor status, and satisfaction. <h3>Results</h3> The median age was 74 (range 60-95). 60% of tumors were squamous cell (SCC) and 40% basal cell (BCC). Tumor grade was rarely reported. Location of tumor was face and scalp (98%), and limb and torso (2%). On physical exam, 23% of tumors were >5 cm and sizes ranged to 9.5 cm. 31% presented with discharge or bleeding and 31% with pain. Tumors were staged as T2-4. CT or ultrasound detected suspicious nodes in 17%. 30% of patients died of any cause in the follow-up period, most from cardiovascular disease. 12 patients died of cancer; 9 pts had SCC and 3 had BCC. All 12 had tumors presenting on the face or scalp and 2 had suspicious L/N at presentation. 70% of patients are alive and disease free, including 58% of patients with SCC and 87.5% of patients with BCC. Patient satisfaction was high with only 2% unhappy with the palliation they received, including those patients who died of other causes. <h3>Conclusion</h3> RT is an effective modality to palliate symptomatic, locally advanced, skin cancers. CT and ultrasound are effective methods of evaluating nodes. When advanced surgical techniques are unavailable, RT may be a reasonable option for treatment. This data will be further mined to assess the effect of treatment fields, RT dose, and fraction size. This study is limited by the lack of physician follow-up, a problem in developing countries.