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Ronald Chen, MD, MPH, FASTRO, hosts a conversation on the background, methodology, primary recommendations, and implications of the updated External Beam Radiation Therapy for Palliation of Symptomatic Bone Metastases: An ASTRO Clinical Practice Guideline. Alongside Tracy Balboni, MD, MPH, and Sara Alcorn, MD, they discuss recent data and changes to practice patterns such as increased use of advanced treatment approaches (e.g., stereotactic radiation) and reirradiation. The guidelines address five key questions in this context, built upon a systematic review of the available literature and with assessment of evidence quality and recommendation strength.