OBJECTIVE: Concern about the radiation-related risks associated with medical imaging is currently a hot topic in both the scientific and lay press as well as gaining a growing awareness from regulatory and legislative organizations. As a result, there is a growing debate about whether or not we should obtain informed consent from patients--in particular, children and their parents--for examinations that expose patients to radiation. In this article, we will discuss the difficulties and challenges of informed decision making and obtaining consent for radiologic examinations. CONCLUSION: We provide our perspectives about the issue of whether informed consent should be required for diagnostic imaging procedures in children, although many of the points also apply to the adult population, and we discuss the dilemmas related to the process of designing and obtaining informed consent for radiologic procedures.