The GEMPix is a small gaseous detector with a highly pixelated readout, consisting of a drift region, three Gas Electron Multipliers (GEMs) for signal amplification, and four Timepix ASICs with 55 µm pixel pitch and a total of 262,144 pixels. A continuous flow of a gas mixture such as Ar:CO2:CF4, Ar:CO2 or propane-based tissue equivalent gas is supplied externally at a rate of 5 L/h. This article reviews the medical applications of the GEMPix. These include relative dose measurements in conventional photon radiation therapy and in carbon ion beams, by which on-line 2D dose images provided a similar or better performance compared to gafchromic films. Depth scans in a water phantom with 12C ions allowed measuring the 3D energy deposition and reconstructing the Bragg curve of a pencil beam. Microdosimetric measurements performed in neutron and photon fields allowed comparing dose spectra with those from Tissue Equivalent Proportional Counters and, additionally, to obtain particle track images. Some preliminary measurements performed to check the capabilities as the detector in proton tomography are also illustrated. The most important on-going developments are: (1) a new, larger area readout to cover the typical maximum field size in radiation therapy of 20 × 20 cm2; (2) a sealed and low-pressure version to facilitate measurements and to increase the equivalent spatial resolution for microdosimetry; (3) 3D particle track reconstruction when operating the GEMPix as a Time Projection Chamber.