The IMRT technique for uterine cancer helps to lower dose to organs at risk, especially the bone marrow. PORTEC-2 also showed comparable outcomes of VB alone compared to external pelvic RT for high-intermediate risk patients. Few reports examine the combination of IMRT+VB, especially in the setting of chemotherapy for advanced patients. Here, we look at the long-term effects of adjuvant IMRT+VB “sandwiched” between carboplatin and paclitaxel chemotherapy (C-T Cx). We reviewed 206 patients treated with adjuvant IMRT+VB and sandwich chemotherapy for Stage I-III uterine cancer from 2009 - 2016. Patients were surgically staged with no visible residual disease. Chemotherapy regimen involved C-T Cx every 21 days for 3 cycles, followed by IMRT+VB, followed by 3 additional cycles of C-T Cx. Patients were to have received at least one cycle post-RT to be included. Toxicities were graded with CTCAE, version 4.03. Rates for local control (LC), distant metastasis (DM), disease-free survival (DFS), and overall survival (OS) were examined using Kaplan-Meier survival curves. Median age and follow-up was 70 years (range: 36-94) and 39 months (range: 6.23-110.1 months), respectively. Ethnicity distribution was 48% African-American, 31% Hispanic, 17% White, 4% Asian, and 1% other. Histological type revealed 42% EAC, 40% UPSC, and 18% CS. FIGO stage distribution: IA-30%, IB-15%, II-16%, IIIA-7%, IIIB-15%, IIIC1-18%, and IIIC2-12%. Grade distribution: 1 – 9.7%, 2 – 8.7 %, 3 – 80.6%. LVSI was present in 51.5% of patients. Twenty-four (12%) patients underwent extended-field IMRT. Acute grade 2 and 3 GI toxicity was present in 17 (8.3%) and 4 (1.9%) patients, respectively. Two (1.0%) patients had acute grade 2, but none had grade ≥3 GU toxicity. Acute grade ≥3 neutropenia, anemia, and thrombocytopenia were present in 33.5%, 10.7%, and 11.7%, respectively. Late grade 2 and 3 GI toxicity was in 8 (3.9%) and 7 (3.4%) patients, respectively, including one with a colovesicular fistula. Five (2.4%) had late grade 2 but none had grade ≥3 GU toxicity. A large portion (21.4%) had grade 1 vaginal stenosis (VS), followed by grades 2 (9.2%) and 3 (1.0%). Stages I-II and III had similar five-year rate of LC (95.2% vs. 91.4%; logrank p=0.94) but significantly different DM rate (22.0% vs 49.6%; logrank p=0.002). Stages I-II and III had significantly different DFS (76.7% vs. 48.9%; logrank p=0.0012) but similar OS (86.0% vs. 85.7%; logrank p=0.79). Compared to EAC, CS was significantly more likely to have worse OS (HR: 7.65, 95% CI 1.53-38.4; p=0.013), DFS (HR: 3.83, 95% CI 1.80-8.15; p=0.0005), and DM rate (HR: 4.27, 95% CI 1.96-9.30; p=0.0003). Although not statistically significant, UPSC trended towards inferior OS (p=0.09) compared to EAC. This study represents the largest cohort of uterine cancer patients receiving adjuvant IMRT+VB “sandwiched” between chemotherapy. Patients have good long-term clinical outcomes and a low toxicity profile.