This review evaluated clinical evidence of surgery, photon-based radiotherapy and proton therapy for clival chordoma. The authors stated that contemporaneous proton therapy series show a local control rate ranging from 70 to 85% at 5 years, arguably better than that for comparable photon-based treatment approaches. There is the growing body of evidence in favor of proton therapy, underlining its potential to improve the management of clival chordomas, and proton therapy will become a significant addition to existing cancer treatment options for Australians.