Hadron therapy is an innovative cancer treatment method based on the acceleration of light ions at high energy. In addition to their interesting profile of dose deposition, which ensures accurate targeting of localized tumors, carbon ions offer biological properties that lead to an efficient treatment for radio-and chemo-resistant tumors and to provide a boost for tumors in hypoxia. This paper is a short review of the progress in theoretical, experimental, fundamental and applied research, aiming at understanding the origin of the biological benefits of light ions better. As a limit of such a vast and multidisciplinary domain, this review adopts the point of view of the physicists, leaning on results obtained in connection with CIMAP's IRRABAT platform. 1. Introduction Interaction of fast ions with biological systems constitutes one aspect of the interdisciplinary researches performed with ion-beam facilities. This domain is as rich as it is complex since it encompasses several orders of magnitude in both space and time. The shortest space and time scale corresponds to atomic collisions, which may be as short as 10 −18 s for the interaction of fast ions with individual atoms. At the opposite end of this domain, late effects – like cancer induction, chromosomal instability or organ dysfunctions – may appear or remain several years after irradiations. While irradiations may be limited to a very localized region, the whole behavior of an organ may be affected, possibly leading to human death, in particular when the irradiation dose and spatial extension are high. Between these two extreme scales, stands a great number of mechanisms, including for instance: the transport of the primary ejected electrons, the relaxation of the ionized and excited molecules, which may lead to direct damage in biological targets and to radical species and associated biochemical reactions. These early physical and chemical stages are followed by numerous and complex cell responses, such as the triggering of mechanisms to check DNA, to repair its damage, to manage the oxidative stress or to induce cell death. The numerous biological endpoints that have been studied reveal the complexity and the diversity of this biological response. These endpoints may involve particular structures of cells at the molecular scale (tracking of protein activities, damage in DNA, protein or lipid) or at the sub-cellular scale (chromosomes, nucleus, membranes, mitochondria.. .) and may concern cell organization (3D cell culture, tissues, organs, body). The domain of low doses