Background: Bevacizumab is FDA-approved for patients with recurrent glioblastoma (GBM). Despite bevacizumab treatment most patients progress, and there are limited therapeutic options for them. We evaluated the role of radiation therapy (RT) after bevacizumab failure in recurrent GBM. Methods: With IRB approval, the Cleveland Clinic’s database was used to identify all recurrent GBM patients who received salvage treatment after initial bevacizumab failure. Patients were stratified by whether or not they received a RT-containing regimen. Kaplan-Meier analysis and log-rank method were used to compare overall survival (OS) and progression-free survival (PFS) from time of initial bevacizumab failure. Univariable and multivariable Cox proportional hazards models were used to assess the association between patient and treatment characteristics and OS. Results: We identified 108 recurrent GBM patients treated after initial bevacizumab failure. Seventeen patients received a RT-based regimen and 91 patients received a non-RT regimen. Of the 17 patients who underwent some form of RT, 5 received RT alone and 12 received RT in combination with other chemo/targeted therapy (11 received RT with bevacizumab). Six patients underwent stereotactic radiosurgery, and 11 patients received fractionated radiation ranging 20 to 60 Gy (4 patients received standard fractionation of 2 Gy per fraction, 6 patients received a hypo-fractionated regimen of > 2 Gy per fraction, and 1 patient’s regimen was unknown). At time of initial bevacizumab failure, both the RT and non-RT groups were similar in age, performance status, and extent of resection. Median OS and PFS for the entire cohort was 6.0 months (95% CI: 5.2, 6.6) and 2.6 months (95% CI: 2.3, 3.1) respectively. The group that received subsequent RT had a statistically significant increase in both OS (8.8 vs 5.4 mos; p = 0.05) and PFS (4.1 vs 2.3 mos; p = 0.006) when compared to the group that did not receive RT. In both univariate and multivariate analyses, only RT use after bevacizumab failure was predictive of OS. Conclusions: In this small cohort, use of salvage RT after bevacizumab failure in recurrent GBM was associated with improved survival. A prospective trial is warranted to confirm this finding.