Since the 1st Edition of Report 81 was published in 1999 by IPEM there have been significant advances in radiotherapy technology. The second edition of Report 81 continues with the aim of providing a reference text to cover quality control (QC) of radiotherapy equipment and guidance on action limits to apply to the QC checks. The updated report includes new content on QC of Tomotherapy, Gammaknife and Cyberknife units as well as updates to previous text on QC of linear accelerators and other radiotherapy equipment. In addition the report discusses implementation of a quality framework and alternative approaches to developing quality control schedules, such as, utilising failure mode and effects analysis. It includes a chapter on management of radiotherapy computer systems and clinical software development provided by IPEM’s Informatics and Computing SIG.