The cell cycle has been inextricably linked to the cellular response to radiation for many years. However, it is only in the past decade that the concept of a coordinated DNA damage response integrating damage recognition, cell cycle checkpoints and DNA repair has begun to be elucidated. The ATM protein is emerging as a key orchestrator of the damage response activating a wide variety of effectors involved in cell cycle arrest and DNA repair to elicit a concerted effort to prevent genome instability caused by unwanted changes in DNA sequence. The key proteins involved in cell cycle checkpoints in different phases of the cell cycle, and their interaction, is a fertile and rapidly developing area of research. This review summarizes the current state of knowledge of cellular checkpoints in response to radiation-induced double-strand breaks in mammalian cells and how this impacts on radiosensitivity.