The role of neutrons in the management of cancer has a long history. However, it is only in recent years that neutrons are beginning to find an accepted place as an efficacious radiation modality. Fast neutron therapy is already well established for the treatment of certain cancers, and clinical trials are ongoing. Californium neutron sources are being used in brachytherapy. Boron neutron capture therapy has been well tested with thermal neutrons and epithermal neutron dose escalation studies are about to commence in the USA and Europe. Possibilities of neutron induced auger electron therapy are also discussed. With respect to chemotherapy, prompt neutron capture analysis is being used to study the dose optimization of chemotherapy in the management of breast cancer. The rationales behind these applications of neutrons in the management of cancer are examined.