After radiotherapy treatment, there is an increased incidence of localized atherosclerosis in patients with Hodgkin's disease, breast cancer, and head and neck cancer. Here, we established a mouse model to study the development and progression of radiation-induced atherosclerosis and to compare the phenotype of these lesions with age-related atherosclerosis. Atherosclerosis-prone ApoE ؊/؊ mice fed a regular chow diet received single radiation doses of 14 Gy or sham treatments (0 Gy) to the neck, including both carotid arteries. At 22, 28, and 34 weeks after irradiation, blood samples were taken, and the arterial tree was removed for histological examination. Cholesterol levels in irradiated mice were not significantly different from agematched controls, and markers of systemic inflammation (soluble intercellular adhesion molecule-1, soluble vascular cell adhesion molecule-1, and C-reactive protein) were not elevated. Earlier diagnosis and better treatment options have lead to improvements in cancer-specific survival for most tumor types, but this also results in an increased number of patients at risk for developing treatment-related side effects. At least one-half of all cancer survivors will have received radiotherapy during their treatment, and vascular injury is the major cause of late radiation morbidity.A meta-analysis of radiotherapy trials for women with early breast cancer showed that the benefit of radiotherapy (5% reduction in cancer related deaths) was offset by a 4% increase in non-breast-cancer-related mortality, mainly late vascular disease that became apparent with longer follow-up.