The use of dual-energy X-ray absorptiometry (DXA) units primarily for the assessment of fracture risk and in the diagnosis of osteoporosis is ubiquitous in Europe and ever-expanding in its implementation worldwide. DXA is known for its reported low radiation dose and precision in the determination of bone mineral density. However, the use of simple suspension criteria, as proposed in the new EC report RP-162, will identify units that are unfit for useful and safe diagnosis. Such suspension levels, however, are not a substitute for regular maintenance, quality control testing and optimisation of clinical outcomes.