Over the past one decade, there was a significant reverse in clinical attitude to the high-dose-rate (HDR) intracavitary brachytherapy for treatment of cervical carcinoma. Cumulative data from both meta-analysis and a few available randomized studies have shown that results of HDR were comparable with, or slightly superior to, that of the existing low-dose-rate (LDR) results. The improvement of treatment results, parallel with a significant reduction of severe rectal complication rate (Grade 3 and 4), has been attributed mainly to the improved physical/mechanical characteristics of HDR facility and the use of appropriately fractionated treatment. Prospective randominzed comparison of HDR vs. LDR, optimal dose-fractionation study, and prediction/prevention of rectal complication are the three central issues of HDR in the future.