Electron spin resonance (ESR) spectroscopy and the Monte Carlo (MC) technique were jointly applied to the physical dose reconstruction of the accident that occurred on 2 December 2001 in Georgia. Three people were exposed to two very-high-activity (2.6×1015 Bq) 90Sr sources. Following this exposure, the two most seriously affected victims exhibited severe radiological injuries localised in the back as well as a haematopoietic syndrome. The information concerning the circumstances of the accident in terms of sequences of irradiation and the exposure time was not clearly established. The physical dose reconstruction of the accident was performed for one victim, treated in France, using both MC simulations and ESR measurements made on one vertebra and two rib samples removed from the victim for medical reasons. The complementary nature of the two tools made it possible to estimate the dose distribution within the body with reasonable accuracy and helped to develop the treatment strategy.