The continuing increase in the worldwide use of X-ray imaging has implications for radiation protection of medical staff. Much of the increased usage could be viewed as simply a workload issue with no particular new challenges. However, advances in technology and developments in techniques have seen an increase in the number of X-ray procedures in which medical personnel need to maintain close physical contact with the patient during radiation exposures. The complexity of many procedures means the potential for significant occupational exposure is high, and appropriate steps must be taken to ensure that actual occupational exposures are as low as reasonably achievable. Further attention to eye protection may be necessitated if a lowering of the dose limit for the lens of the eye is implemented in the near future. Education and training in radiation protection as it applies to specific situations, established working procedures, availability and use of appropriate protective tools, and an effective monitoring programme are all essential elements in ensuring that medical personnel in X-ray imaging are adequately and acceptably protected.