Interest in α-emitters for radiotherapy is increasing, with only 225Ac, 212Pb, and 211At having realistic chances of market availability within 10 years. 212Pb, with a half-life of 10.64 hours, is a β-emitter that decays into 212Bi (a 60.5-minute half-life α-emitter) and 212Po (a pure α-emitter). While 212Pb is not ideal due to the γ-ray emission from 208Tl, its short half-life reduces radioactive waste and allows for targeted therapy. 212Pb's β-particle contribution is non-negligible and could reduce treatment doses. Chelating agents are crucial for retaining 212Bi within the molecule, and progress has been made in this area. 212Pb offers advantages over cocktails of therapies, providing efficacy in both large tumors and micrometastases. Imaging with 212Pb is feasible but limited to development purposes, with 203Pb as a potential surrogate. 212Pb production routes include decay of 228Th, with three main processes. Orano Med is leading in production, with plans for industrial facilities. 212Pb could also be produced directly from 226Ra. Access to precursors 228Th and 226Ra is available, with 226Ra being the main starting material for 223Ra and 225Ac. Industrial access to 212Pb is not yet ready, but many companies are developing new approaches. Over 20 212Pb molecules are in development, with 7 in clinical trials. There is optimism that large-scale production will be available by 2028, potentially replacing 225Ac by 2035–2045. No conflicts of interest were reported.Interest in α-emitters for radiotherapy is increasing, with only 225Ac, 212Pb, and 211At having realistic chances of market availability within 10 years. 212Pb, with a half-life of 10.64 hours, is a β-emitter that decays into 212Bi (a 60.5-minute half-life α-emitter) and 212Po (a pure α-emitter). While 212Pb is not ideal due to the γ-ray emission from 208Tl, its short half-life reduces radioactive waste and allows for targeted therapy. 212Pb's β-particle contribution is non-negligible and could reduce treatment doses. Chelating agents are crucial for retaining 212Bi within the molecule, and progress has been made in this area. 212Pb offers advantages over cocktails of therapies, providing efficacy in both large tumors and micrometastases. Imaging with 212Pb is feasible but limited to development purposes, with 203Pb as a potential surrogate. 212Pb production routes include decay of 228Th, with three main processes. Orano Med is leading in production, with plans for industrial facilities. 212Pb could also be produced directly from 226Ra. Access to precursors 228Th and 226Ra is available, with 226Ra being the main starting material for 223Ra and 225Ac. Industrial access to 212Pb is not yet ready, but many companies are developing new approaches. Over 20 212Pb molecules are in development, with 7 in clinical trials. There is optimism that large-scale production will be available by 2028, potentially replacing 225Ac by 2035–2045. No conflicts of interest were reported.