Patients were treated at a single institution to a dose of 30 Gy in five fractions delivered every other day using image‐guided intensity modulated radiation therapy (IMRT) partial breast irradiation. A total of 34 patients were treated with a median follow‐up of 4.6 months. The rate of acute Grade 1 dermatitis was 23.5% (n = 8), and Grade 1 fatigue was 17.6% (n = 6), with no Grade 2 or higher acute toxicities. The rate of chronic Grade 1 dermatitis was 25.0% (n = 6), Grade 1 fat necrosis 4.2% (n=1), with no patients demonstrating other chronic toxicities. Image‐guided APBI delivered with IMRT is associated with low rates of acute and chronic toxicity though additional follow‐up is warranted.