Background:The aim of this study is assess the dosimetric results and early and late adverse effects of radiotherapy with tomotherapy in localized prostate cancer patients. Material and Methods: Treatment results and early and late adverse effects in 60 patients who had undergone curative radiotherapy due to prostate cancer and who had been followed up for at least 6 months in the post-treatment process were assessed retrospectively. 28 of the patients were in the lowintermediate risk group, whereas 32 were in the high-risk group. 74 Gy radiotherapy was delivered to the prostate with simultaneous integrated boost strategy, 60 Gy to seminal vesicles, and 52 Gy to pelvic lymph nodes of the cases. Patients with at least 6 months of post-treatment follow-up were assessed in terms of early and late adverse effects. Results: Twenty patients had grade 1, and two patients had grade 2 acute genitourinary toxicity, whereas 15 patients had grade 1, and 4 patients had grade 2 acute gastrointestinal toxicity. Twelve patients had grade 1, and 3 patients had grade 2 late genitourinary toxicity, 6 patients had grade 1, and two other patients had grade 2, and grade 3 late gastrointestinal toxicity. Biochemical recurrence developed in four patients. One of the patients with recurrence died in the 14 th month of recurrence due to organ metastasis. Conclusions: Image-guided dose-escalated radiotherapy with IMRT technique is a reliable method in prostate cancer treatment. Increased toxicity was not observed in the cases with lymph node irradiation despite the increased radiotherapy field.