High-dose-rate intracavitary radiation (HDR-ICR) for gynecologic brachytherapy has developed clinically over the past 15 to 20 years in Europe and Asia and is becoming more prevalent in North America. Brachytherapy given at dose rates of 0.5 to 5.0 Gy/minute means that an intracavitary procedure that previously required hospitalization and bed rest for several days can be administered over a short time on an outpatient basis. High-dose-rate remote afterloading brachytherapy has brought about the development of new computer-controlled treatment units, modification of treatment techniques for outpatient therapy, altered dose schedules of external beam and intracavitary irradiation, and revised dose specification definitions. A review of the literature on high-dose-rate brachytherapy for cervical and endometrial carcinoma demonstrates that local control, survival, and acute and late sequelae are comparable to traditional low-dose-rate brachytherapy.