Objective To evaluate the reproducity of planning and impact of organ at risk in CT image guided three-dimensional high dose rate ¹⁹²Ir brachytherapy in cervical cancer by dosimetric analysis. Methods Ten patients with FIGO stage Ⅱ_b or Ⅲ_b of cervical cancer were selected who were treated with CT image guided three-dimensioned high-dose-rate ¹⁹²Ir brachytherapy. Patients underwent a CT scan in each fraction of brachytherapy and treatment plans were made. Prescription dose to point A with 7 Gy per fraction and graphical optimized with organs at risk (OAR) dose limitations of D_{2 cm³}≤5 Gy in rectum and sigmoid and D_{2 cm³}≤5.5 Gy in bladder. The optimized plan for the first fraction in each patients as the standard planning based on which the optimization planning for the following fractions. The dose volume histogram ((high risk clinical target volume (HRCTV) D₉₀, bladder D_{2 cm³}, rectum D_{2 cm³} and sigmoid D_{2 cm³}) were evaluated and compared between the two groups of planning. Planning comparison analysis used independent samples t-test and OAR parameters with Pearson correlation analysis. Results HRCTV D₉₀ were not statistically significant difference between the optimization and standard planning (t=－0.03—－1.61,P=0.978—0.128). D_{2 cm³} of bladder, rectum and sigmoid were statistically higher in the standard plans (t=－2.27—－3.35,P=0.049—0.004). D_{2 cm³} of bladder, rectum and sigmoid correlated positively with the absolute volume respectively (r=0.314,0.407,0.539,P=0.026,0.003,0.000). Conclusions It′s necessary for the multiple planning for CT image guided brachytherapy in cervical cancer. The bigger volume of OAR, the higher D_{2 cm³}.