In this article, the authors review the motivations for and processes of building international collaborations in radiotherapy. Four specific examples of Emory University's institutional experience are presented. First, the authors describe their experiences in Georgia, including the development of the Atlanta-Tbilisi Healthcare Partnership and associated departmental site visits and exchange programs. Next, they discuss the collaboration in Ahmedabad, India, the centerpiece of which was the Indo-American Collaborative Workshop on Radiotherapy. Finally, the authors discuss shorter site visits in the Czech Republic and in Argentina and the benefits of international collaborations to both visiting and host institutions.