Ra-223, a calcium analogue with alpha radiation, has been approved by the US FDA in 2014 for the treatment of castration-resistant, intractable prostate cancer patients with bony metastases. The advantages of Ra-223 over other bone pain seeking radio-agents in treating these patients are: lower radiation exposure to adjacent normal tissue, stronger therapeutic effects on target lesions, a suitable radiation half-life and energy for therapeutic purpose, and a significantly prolonged overall survival period. Comparable clinical trials are also being conducted in Taiwan. As partners of the therapeutic group, specialists in the nuclear medicine community should realize Ra-233's therapeutic procedures, safety and radiation considerations, and its potential side effects, so as to optimize any therapeutic regiment.