Traditionally, cervical brachytherapy has been prescribed to point A. However, since the Groupe Européen de Curiethérapie and European Society for Radiotherapy Oncology guidelines were published, image-guided brachytherapy has become an emerging technique. The purpose of this study was to evaluate the highrisk clinical target volume HR-CTV coverage and analyze dose-volume histograms for organs at risk in point A prescription of high-dose-rate brachytherapy. A total of 68 patients with locally advanced cervical cancer were treated with three-dimensional conformal external beam radiation therapy and brachytherapy from December 2012 to March 2017. Fractions of 6 Gy for a total of 12-24 Gy were delivered at point A by brachytherapy to all patients. Following each brachytherapy application, a pelvic computed tomography scan was performed and imported into a threedimensional brachytherapy treatment planning system. In this study, the HR-CTV, bladder, and rectum were re-delineated according to Report 89 of the International Commission on Radiation Units and Measurements using the magnetic resonance images at the time of diagnosis, and the dose-volume histogram of each structure was analyzed. The median age of patients at diagnosis was 67 years range, 31-91 years. Mean HR-CTV D 90 for all patients was 558.3 cGy range, 228.7-1005.1 cGy and the mean HR-CTV D 90 within each clinical T stage was : Ib, 646.4 cGy ; 2a, 579.3 cGy ; 2b, 545.2 cGy ; 3a, 556.6 cGy ; 3b, 451.3 cGy ; and 4, 497.9 cGy. HR-CTVD 90 was correlated with HR-CTV. The mean D2 cm 3 was 678.1 cGy for the bladder and 511.9 cGy for the rectum. Using point A-based dose prescription, HR-CTV coverage was insufficient, especially in cases with a large tumor volume or a high T stage. Image-guided brachytherapy is expected to improve HR-CTV coverage while keeping rectal and bladder doses within acceptable levels.