In 1922 the Québec government appropriated $100,000 for the purchase of radium to found an Institut du Radium at the University of Montreal. Opened largely through the initiative and drive of Dr. Joseph-Ernest Gendreau, the institut was the first organization devoted to radium therapy and cancer treatment in Canada. This paper describes the background, origins and development of the Institut with a focus on the medical, political, and cultural factors which led to its establishment. From the point of view of the Québec government, the Institut was a way of showing its commitment to health care, of strengthening cultural bonds with France, and of demonstrating the province's emerging technological prowess. Radium was to be an adornment which showed off the scientific advancement of 20th century Québec. Unfortunately, the Institut never achieved the scientific or cultural stature promised by the rhetoric. Which surrounded its opening, and this paper will examine the factors which led to its instability and eventual demise. In addition to an overwhelming clinical workload, chronic underfunding and geographic isolation, the Institut fell victim to medical politics. Its success was undermined by opposition from medical groups and competition from hospitals which led to the establishment of multiple radium centres in Montreal. A fundamental problem was confusion over whether its role should be a research institute, a general medical clinic, or a specialized cancer centre. Despite numerous financial and administrative crises and the severing of its academic affiliation in 1945, the Institut survived until 1967. Despite its troubled history, the Institut made an important contribution to Canadian medicine through its ground braking role in the establishment of radiotherapy and cancer treatment. In addition, the lessons learned from its difficulties proved useful to other provinces planning their own cancer programs.