Radiation therapy (RT) is an essential treatment modality for cancer care and cure. Over the years, radiation treatments have become more complex and more computerized leading to highly precise treatment approaches maximising loco-regional control while minimizing toxicity. Safe and effective radiotherapy delivery however requires the implementation of adapted quality assurance (QA) programs and integral quality management (QM) systems, favouring continuous quality improvement. These improvements can arise within the local or departmental context, but they can also be favoured by national programs and incentives. The Belgian College of Physicians for Radiation Oncology Centres ('the College') is a federal entity-composed mainly of radiation oncologists, medical physicists, radiation therapists and quality managers-whose mission is to improve the quality of radiotherapy by organizing peer review activities. Throughout the past decades, the College has been the source of numerous national initiatives, which have fostered and accompanied radiotherapy departments in taking the steps towards increased quality of care. With this review, we aim to share these national quality-oriented projects instigated by the College. These include the introduction of peer-reviewed target volume contouring programs, the organisation of clinical audits and external beam dosimetry audits as well as the implementation of a national adverse event analysis system and the collection and analysis of RT-specific quality indicators.