Abstract: Postmastectomy radiotherapy has oncological benefits. However, it can cause deleterious surgical outcomes after immediate breast reconstruction and may compromise a favorable aesthetic result. This article summarizes the interaction between radiotherapy and immediate breast reconstruction, as well as the factors that affect the complications of radiotherapy. In conclusion, the interaction between radiotherapy and immediate breast reconstruction is decreasing with individual reconstructive plan and improvement of technique. Immediate breast reconstruction may be performed for patients who have the possibility of postmastectomy radiotherapy and are eager to undergo immediate breast reconstruction. However, further prospective clinical research should be conducted to test this point. The possible interaction between radiotherapy and immediate breast reconstruction should be discussed with the patients preoper- atively.