The purpose of this study is to investigate factors affecting bladder ICRU reference point dose in gynecologic cancer patients receiving intracavitary brachytherapy. Forty seven different intracavitary HDR brachytherapy applications were performed using tandem-ovoid (n=25), vaginal ovoid (n= 17) and tandem-cylinder (n=5) in 43 patients diagnosed with cervical (n=29), endometrial (n=12) and vaginal (n=2) carcinoma. Effect of applicator type, number of pregnancy and delivery, and type of hysterectomy in operated patients on ICRU bladder reference point dose was investigated. ICRU bladder reference point dose was significantly higher in tandem-cylinder applications than in vaginal ovoid alone or tandem-ovoid applications (p=0.009). No difference was found between vaginal ovoid alone and tandem-ovoid applications. Number of pregnancy and delivery had no effect on bladder dose. Bladder reference point dose was significantly higher in patients underwent type 3 hysterectomy compared to type 1-2 hysterectomy (p<0.00 1). Several factors affect bladder dose during gynecologic intracavitary brachytherapy. Patient and applicator related factors should be evaluated together and any necessary changes needed should be made in the treatment plan accordingly.