The effect of dose rate on clonogenic cell survival and DNA double-strand breaks (DSBs) has been examined in a human bladder carcinoma cell line, RT112, treated with ionizing radiation. Cell survival changed markedly over the range of dose rates used (0.01-1.28 Gy/min) with the curves becoming shallower and straighter as the dose rate was lowered. Similarly, the number of DSBs measured by pulsed-field gel electrophoresis (PFGE) immediately after irradiation varied with dose rate. Fewer DSBs were detectable after low-dose-rate irradiation. However, when a 4-h repair period was allowed after irradiation, cells treated at all dose rates exhibited approximately the same amount of damage. The final level of unrejoined DSBs, as detected by PFGE, therefore does not correlate with cell survival at different dose rates.