Radiotherapy is now a widely accepted treatment modality in oncology. Plaque brachytherapy is an effective eye and vision sparing alternative to enucleation for patients with intraocular tumours. The most common indication for brachytherapy is malignant tumours like retinoblastoma and uveal melanoma. Over the years, brachytherapy is being increasingly used for other conditions affecting the eye and ocular adnexa. These include ocular surface tumours and some benign lesions where traditional methods of treatment have failed such as retinal capillary hemangiomas, vaso-proliferative tumours, choroidal hemangiomas and choroidal neovascularization in age-related macular degeneration. The expanded applications of plaque therapy are summarized in this review.