Improvements in cancer survival have led to a growing interest in the prevention of cancer therapy-related adverse events. Among these, cancer therapy-related cardiovascular toxicity (CTR-CVT) is an important cause of morbidity and premature mortality during and after cancer treatment. To assist healthcare professionals in the prevention, monitoring and management of CTR-CVT, the European Society of Cardiology (ESC), in collaboration with the European SocieTy for Radiotherapy and Oncology (ESTRO), the European Hematology Association (EHA) and the International Cardio-Oncology Society (IC-OS), have published the 2022 ESC Guidelines for cardio-oncology. In this article, we summarise the recommendations that can help radiation oncologists in the prevention and monitoring of radiation-induced heart disease (RIHD), and highlight areas where more research and evidence are needed.