Heavy ion radiotherapy awakens worldwide interest recently. The clinical results obtained by the Heavy Ion Medical Accelerator in Chiba at the National Institute of Radiological Sciences in Japan have clearly demonstrated the advantages of carbon ion radiotherapy. Presently, there are four facilities for heavy ion radiotherapy in operation, and several new facilities are under construction or being planned. The most common requests for ion sources are a long lifetime and good stability and reproducibility. Sufficient intensity has been achieved by electron cyclotron resonance ion sources at the present facilities.