Fast neutrons and protons undergo fundamentally different interactions in tissue. The former interact with nuclei, while the latter, as in the case of photons, interact mainly with atomic electrons. Protons do, however, also undergo some nuclear reactions, the probability of which increases with proton energy. The determination of the reference absorbed dose in a patient for the two modalities is described. Two internationally accepted protocols have been formulated and have been published in ICRU reports. For both modalities the practical means for determining the reference absorbed dose in a patient involves the use of thimble ionization chambers calibrated in