Introduction: Many cancer patients require radiation therapy and often experience adverse effects including erythema, itching, and pain. Aloe vera has been studied for its potential use in the prevention and treatment of radiation related adverse effects as it possesses a variety of properties and is considered an antioxidant and anti-inflammatory agent. Multiple controlled trials have been performed in order to evaluate the efficacy of aloe vera for the prevention and treatment of radiation side effects. Previous systematic reviews have examined the use of aloe vera for radiation-induced skin reactions, however updated literature now includes the use of aloe vera in proctitis. Objectives: The aim of this comprehensive review is to summarize and evaluate the use of aloe vera in patients who have undergone radiation therapy for the treatment of cancer. Results: Aloe vera may not be effective for prophylaxis or treatment of radiation adverse effects in breast cancer patients. Moderate efficacy was seen when aloe vera was used in combination with mild soap versus soap as monotherapy for the treatment of radiation skin reactions. Aloe vera may be effective when cumulative radiation doses are greater than 2,700cGy and for acute radiation proctitis. Conclusions: There is contradictory evidence for the use of aloe vera in the setting of radiation in regards to its efficacy in the prevention and treatment of radiation-induced adverse effects. Disciplines Disciplines Pharmacy and Pharmaceutical Sciences Comments Comments