Background: Radiation sequelae can be early or late depending on the duration of occurrence. Early reactions are temporary but late reactions tend to be permanent and occur many years after treatment. Late reactions can be seen in skin, subcutaneous tissue, muscle and bone in the irradiated area. Material & Method: We present here a report in which we saw all the late reactions in a single patient 18 years after radiotherapy to pelvis for cancer cervix. Results: Our patient has bone fracture, new bone formation, bone marrow widening, muscle hypertrophy, subcutaneous fibrosis and angiokeratoma developed simultaneously after 18 years of radiotherapy to pelvic area. Conclusion: All these types of late toxicities are rarely seen in the same patient and we could not find any such reports in the literature. 

Keywords: Late Radiation Toxicity; Bone; Muscle and Skin Simultaneously; Pelvis.