Background to the audit: Locally advanced cervical cancer is treated with chemoradiotherapy and brachytherapy.[1],[2] Guidelines support the implementation of image-guided brachytherapy (IGBT).[3],[4] [5] IGBT allows dose escalation whilst minimising dose to organs at risk, improving local control and survival.[6] Interstitial needles improve coverage of the high risk clinical target volume (HR-CTV) particularly when the tumour is large (>5 cm).