Systemic therapy for cancer is evolving rapidly, with drugs that promote anti-tumour immunity becoming ever more present in the clinic. Immunotherapy is now standard therapy for several cancers including melanoma, lung cancer, renal cell cancer, head and neck cancer, urothelial cancer, and Hodgkin’s lymphoma. It is anticipated that most patients will be treated with immunotherapy in the near future. Immunotherapy is a vastly different treatment to conventional cytotoxic and targeted therapies, with a different mechanism of action, response kinetics, durability and toxicity profile. Immunotherapy toxicities are immune based, can affect any organ at any time, and require vigilance and prompt management. Care for patients receiving immunotherapy requires a different approach to other treatments, and requires close supervision of patients in the community as well as an expert team of physicians able to manage immune toxicity. This talk will outline the nature and best management of common toxicities, and provide an organizational framework to safely manage patients on immunotherapy.