Hadrontherapy with protons and carbon ions is a fast developing methodology in radiation oncology. The accelerators used and planned for this purpose are reviewed starting from the cyclotrons used in the thirties. As discussed in the first part of this paper, normal and superconducting cyclotrons are still employed, together with synchrotrons, for proton therapy while for carbon ion therapy synchrotrons have been till now the only option. The latest developments concern a superconducting cyclotron for carbon ion therapy, fast-cycling high frequency linacs and 'single room' proton therapy facilities. These issues are discussed in the second part of the paper by underlining the present challenges, in particular the treatment of moving organs. © 2010 Elsevier B.V.