Background: Breast cancer is the most common cancer in women worldwide, second most common malignancy in Egypt. Methods: 60 early-stage breast cancer patients who underwent breast-conserving surgery were clusterized into 2 groups: Arm A hypofractionation with concomitant boost and Arm B conventional fractionation, each compromising 30 early stage breast cancer patients.  Assessment of cosmetic outcome after breast irradiation was recorded in both groups in 4 intervals to correlate cosmesis in relation to different irradiation schedules and boost dosage and timing. The study was conducted from April 2016 till December 2018, 32 months were obtained to assure that all patients completed their irradiation schedule and 12 months follow-up period. Results: Lowest cosmetic outcome was recorded immediately after completion of breast irradiation with excellent/good in 66.7% and 73.3% of patients and fair/poor in 33.3% and 26.7% in Arm A and B, respectively. Improvement in cosmesis after 12 months of breast irradiation reaching excellent/good in 83.4% and fair/poor in 16.7% in both Arm A and B. Conclusion: An abbreviated 4-week hypofractionated schedule with a concomitant boost is as effective as conventional irradiation with comparable cosmesis and may be a reasonable alternative following breast conserving surgery.