An algorithm for optimizing beam orientations and beam weights for conformal radiotherapy has been developed. The algorithm models the optimization of beam orientations and beam weights as a problem of mixed integer linear programming (MILP), and optimizes the beam orientations and beam weights simultaneously. The application process of the algorithm has four steps: (a) prepare a pool of beam orientation candidates with the consideration of avoiding any patient-gantry collision and avoiding direct irradiation of organs at risk with quite low tolerances (e.g., eyes). (b) Represent each beam orientation candidate with a binary variable, and each beam weight with a continuous variable. (c) Set up an optimization problem according to dose prescriptions and the maximum allowed number of beam orientations. (d) Solve the optimization problem with a ready-to-use MILP solver. After optimization, the candidates with unity binary variables remain in the final beam configuration. The performance of the algorithm was tested with clinical cases. Compared with standard treatment plans, the beam-orientation-optimized plans had better dose distributions in terms of target coverage and avoidance of critical structures. The optimization processes took less than 1 h on a PC with a Pentium IV 2.4 GHz processor.