The effect of cranial radiation therapy (CRT) on visual attention was examined in long-term survivors of childhood acute lymphoblastic leukemia (ALL) compared to peers with no history of ALL (n = 24) using a cued orienting task and a global–local task. ALL participants treated with CRT (n = 13) demonstrated an increased cost in response time with invalid spatial orienting cues and inefficient shifts of attention across hierarchical levels. ALL participants treated only with chemotherapy (n = 8) showed performance similar to the non-ALL comparison group. Participants with exposure to CRT early in life appeared to largely account for the attention deficits, and showed particular difficulties with shifting attention from the local level of stimuli to the global level. The data are consistent with prior reports emphasizing attention deficits following CRT, and suggest that attention shifting may be particularly affected by CRT early in life. (JINS, 2004, 10, 211–220.)