The paper reconsiders indications for teleradiotherapy (TRT) in children with retinoblastoma (RB) after primary enucleation depending on the prognostic risk factors based on histological findings. Orbital radiation applied in a cumulative focal dose of 50 and 30 Gy to metastatic areas (bones, lymph nodes) is one of the effective methods for the prevention of recurrent RB in children with extraocular extent after chemotherapy and surgical tumor removal (eye enucleation or orbital exenteration). No high histological risk factors make it possible to avoid TRT that increases the risk of death from a second malignancy. Combined chemoradiation therapy did not lose its value in the organ-saving treatment of children with disseminated intraocular RB. There is a greater interest in treating intraocular RB with chemotherapy in combination with local treatment options (brachytherapy, laser photocoagulation, cryotherapy, etc.).