Patient safety has typically been underemphasized in pediatric radiology. There are many reasons why this is the case, including the emphasis on technology in the specialty of radiology as well as inherent differences in the physician-patient relationship. However, radiologists have the same responsibility as other pediatric health care providers for protecting the welfare of the children (and families) undergoing imaging evaluation. This responsibility goes beyond the typical focus of safe practice in radiology, which includes radiation protection and administration of intravenous contrast media and sedative agents. Radiologists must work with clinical colleagues to develop a comprehensive safety program that crosses specialties and incorporates the components of contemporary models, including a focus on communication (especially at the local, patient care level), adherence to protocol (minimizing human contribution), and nonpunitive procedures for error reporting and review. © 2006 Elsevier Inc. All rights reserved.