Initiated by complaints of image artifacts, a thorough visual and radiographic investigation of 197 Fuji, 35 Agfa, and 37 Kodak computed radiography (CR) cassettes with imaging plates (IPs) in clinical use at four radiology departments was performed. The investigation revealed that the physical deterioration of the cassettes and IPs was more extensive than previously believed. It appeared that many of the image artifacts were the direct result of premature wear of the cassettes and imaging plates. The results indicate that a quality control program for CR cassettes and IPs is essential and should include not only cleaning of the cassettes and imaging plates on a regular basis, but also visual and radiographic image inspection to limit the occurrence of image artifacts and to prolong the life cycle of the CR equipment.