This publication addresses the issue of accidental exposures of radiotherapy patients and how to avoid them. More proactive approaches are required to anticipate and thus avoid situations that could lead to accidental exposures. In this context, the International Atomic Energy Agency (IAEA) and the Ibero American Forum of Radiation and Nuclear and Safety Regulatory Agencies (the FORO) have applied proactive methods, such as probabilistic safety assessment to radiotherapy treatments with accelerators. The methodology and results of this exercise are described in this publication.