For over 50 years, electron beams have been an important modality for providing an accurate dose of radiation to superficial cancers and disease and for limiting the dose to underlying normal tissues and structures. This review looks at many of the important contributions of physics and dosimetry to the development and utilization of electron beam therapy, including electron treatment machines, dose specification and calibration, dose measurement, electron transport calculations, treatment and treatment-planning tools, and clinical utilization, including special procedures. Also, future changes in the practice of electron therapy resulting from challenges to its utilization and from potential future technology are discussed.