In this study, we investigated whether a digital photograph of a lateral cephalometric radiograph can produce measurements as accurate as those from a digital image created with a flatbed scanner.Twenty pretreatment lateral cephalograms were randomly selected from the patient files at Chesterfield Royal Hospital. Each radiograph was photographed with a digital camera and scanned with a flatbed scanner. Both images were digitized with imaging software (Dolphin, Chatsworth, Calif). Common cephalometric analyses were performed on both images, and the measurements were recorded. The paired Student t test was used to test for statistically significant differences between the measurements of the images.Angular measurements were not significantly different between the photographed and scanned images, but linear measurements were.It is acceptable to use digital photographs of cephalograms if angular measurements are primarily required. However, these images might not be acceptable if linear measurements are needed.