Radiation therapy holds a key position in the arsenal of cancer treatment methods. This non-invasive technique has been actively used for several decades and has demonstrated high effectiveness in combating various types of malignant tumors. Despite significant advancements in ionizing radiation delivery technologies and the introduction of targeted radiosensitizing drugs and immunotherapy, classical radiation therapy faces limitations related to the radioresistance of tumor cells. This resistance is caused by numerous factors, such as genetic mutations, the metabolic characteristics of cancer cells, their ability to repair DNA, the presence of a tumor microenvironment, and many others. Tumor radioresistance reduces the success of treatment, making it necessary to explore new approaches to enhance the effectiveness of radiation therapy. This review discusses the main principles of radiation therapy and the properties of cancer cells that affect their radiosensitivity. It examines both existing methods for overcoming the radioresistance of cancer cells and prospects for further development, which could significantly improve the effectiveness of cancer treatment.