Background: Patients receiving radiation therapy treatment often exhibit pain as a consequence of their cancer or treatment, and is a major factor affecting the patient’s quality of life and functional status. Accreditation standards require pain to be assessed and managed, which are key components in successful implementation of a radiation therapy plan of care. Multifactorial causes for cancer pain, the subjective nature of pain assessment, and the protracted nature of radiation delivery make it necessary to routinely evaluate patient pain using quantifiable metrics. These evaluations can then be used to develop and evaluate effectiveness of interventional strategies. Methods: Internal “spot check” chart review in early 2015 showed deficits in 16 of 37 charts (43.2%) reviewed for pain assessments, revealing documentation well below the required threshold (95%). As a result, the Department of Radiation Therapy revised the process for the accepted 10-point intensity scale to evaluate patient pain. This revised process included staff re-education, workflow adjustments, and nursing evaluation prior to, during, and the end of the radiation treatment course using a standardized pain scale form. Documentation was accomplished by means of vital sign template encounter tool used by Nursing at the time of initial consult, for weekly on-treatment visits (OTVs), and end of treatment (EOT) encounter. Results: Data were monitored for the period of April-June 2015 and reported as a continuous quality improvement (CQI) activity to the department’s Quality Committee. Amassed data showed a total of 186 unduplicated patients were treated during this period, and 181 (97.3%) were assessed for pain. Conclusions: Ongoing monitoring is an important strategy to assure complete evaluation, treatment and outcomes of patient pain while receiving radiation treatment. A clearly defined and quantifiable process is important to facilitate monitoring and ongoing pain management. Improvements in consistency of pain assessment and management promote enhanced focus on patient pain and contribute to delivery of care, and patient quality of life and performance status.