Abstract: Radiotherapy for pediatric neuroblastoma has undergone continuous evolution in recent decades to establish its role in combined modality management. Despite extensive clinical experience, the precise role of radiotherapy in neuroblastoma remains unclear. Its evolution is still far from over, and more prospective randomized trials are needed to provide more evidence to guide development of optimal radiotherapy treatment schedules. This review analyzes evidence from major multi-institutional prospective trials as well as large retrospective institutional series of neuroblastoma cases to determine the current radiotherapy standards and controversies. The indications for radiotherapy, radiation dose-fractionation, timing, target volumes, and treatment planning are reviewed. A summary of evidence-based consensus recommendations is presented, and unresolved aspects are discussed.