First-line palliative radiotherapy for painful bone metastases is an effective treatment whatever its fractionation (single or multiple fractions). It is also advisable after failure or insufficient effect of a first irradiation, or the appearance of new painful site. Other indications are spinal cord compression, either as an adjuvant to surgery or as sole treatment, and after surgery for long-bone metastases. The development of high-precision techniques (stereotactic conditions) enlarges the possibility of re-irradiation while tolerance doses to normal tissues have already been delivered. Local control and possibly overall survival could be improved in oligometastatic patients.