Liver metastases are a common manifestation of advanced cancer, with potential for significant symptom burden and impairment in quality of life. While systemic therapy remains the standard in management, there are instances when local therapies such as surgical resection or radiofrequency ablation may be offered to control or possibly eradicate hepatic metastatic disease; however, not all patients are suitable for these techniques. There has been increasing interest in the use of radiotherapy (RT) to treat liver metastases, especially with the recent emergence of advances in technology that permit localized ablative radiation doses to a single or few liver targets. This method, known as stereotactic ablative body radiotherapy (SABR) refers to focused, high dose RT delivered in a limited number of treatment sessions. No randomized studies to date have demonstrated superiority of SABR versus other common therapies for liver metastases, but several prospective and retrospective studies have yielded results that are favourable with respect to local control and low risk of significant toxicity. Unfortunately, many patients are still at significant risk for distant progression, emphasizing the need for improved synergism strategies between SABR and systemic therapy. Quality of life and patient reported outcomes have been poorly addressed in this population and will also be explored. Furthermore, cost-effectiveness of these technologies should be considered as a part of the treatment decision making process. In patients where metastatic liver disease is more diffuse, there is a limited role of palliative RT for purposes of symptom control. Delivering high radiation doses to all lesions is not feasible due to the whole liver tolerance to radiotherapy; however, a low-dose whole liver radiotherapy (WLRT) strategy may be useful to palliate symptoms such as pain and nausea. The main focus of this chapter will be to discuss the roles of SABR and WLRT as they pertain to planning, treatment delivery, and outcomes in patients with metastatic liver disease. Issues related to quality of life, patient reported outcomes and cost-effectiveness will also be explored as important aspects of the treatment decision making process.