Like linac-based treatments, proton treatments can benefit from surface-guided radiation therapy (SGRT). However, some of the fundamental difference between linac-based and proton therapy lead to unique benefits and challenges in utilizing SGRT for proton therapy. This chapter provides a discussion of the benefits and challenges of SGRT for proton therapy. The benefits discussed include: patient setup, patient tracking during treatment, respiratory motion management, assessment of patient changes, immobilization device assessment, the potential for reduced anesthesia for pediatric patients, and robotic couch motion assessment. The challenges discussed include: nonstandard camera positioning, treatment nozzle positioning, and SGRT system isocentric calibration.