Nanosecond Q switched pulses and radial polarization are established stand-alone techniques for enhanced laser materials processing applications, but are generally challenging to achieve simultaneously at high average power levels. Here, we demonstrate a 20.6 W radially polarized Ho:YAG rod laser which has been actively Q switched in order to generate 515 μJ, 210 ns pulses at 2097 nm. By utilizing an ultra-low-loss spatially variant birefringent wave plate (S-waveplate) inside the laser cavity, the linearly polarized fundamental mode has been converted to a radially polarized donut-shaped beam with very high conversion efficiency.