Purpose: To assess the delayed effect of hypofractionated radiation therapy with concomitant boost for the treatment of localized prostate cancer and comparing it to conventionally fractionated sequential IMRT , regarding treatment toxicity, biochemical control, patient convenience and quality of life. Patients and Methods: The current study is an extension of previously reported pilot prospective study was conducted on 20 patients at the Clinical Oncology and Radiation Department (NEMROCK), Faculty of Medicine ,Cairo University, Patient data were obtained through the review of hospital records ,calling and interviewing patients, filling EORTC QLQ- C30 and EORTC QLQ- PR 25 questioner and reporting PSA total and free and (RTOG_EORTC late radiation morbidity scoring schema was used to report late toxicity. Results: the median follow up was 26 months the bRFS was 80% in both arms and only one patient develop ≥ grade 2 rectal toxicity and one patient develop ≥ grade 2 GU toxicity. Conclusion: Hypofractionated intensity modulated radiation therapy of localized prostate cancer is a feasible procedure with comparable late gastro-intestinal and genitourinary toxicity rates together with a quality of life, PSA control and patient convenience comparable with conventionally fractionated radiation therapy.