The American Association of Physicists in Medicine ͑AAPM͒ presents a new protocol, developed by the Radiation Therapy Committee Task Group 61, for reference dosimetry of low-and mediumenergy x rays for radiotherapy and radiobiology (40 kVрtube potentialр300 kV). It is based on ionization chambers calibrated in air in terms of air kerma. If the point of interest is at or close to the surface, one unified approach over the entire energy range shall be used to determine absorbed dose to water at the surface of a water phantom based on an in-air measurement ͑the ''in-air'' method͒. If the point of interest is at a depth, an in-water measurement at a depth of 2 cm shall be used for tube potentials у100 kV ͑the ''in-phantom'' method͒. The in-phantom method is not recommended for tube potentials Ͻ100 kV. Guidelines are provided to determine the dose at other points in water and the dose at the surface of other biological materials of interest. The protocol is based on an up-to-date data set of basic dosimetry parameters, which produce consistent dose values for the two methods recommended. Estimates of uncertainties on the final dose values are also presented.