Introduction: Radiographer´s usual role in the medical imaging chain is to acquire relevant and qualitatively good images that help the radiologist or physician to diagnose most accurately. After the image acquisition, the radiographer does a quality evaluation based on established imaging criteria to decide if the image is satisfactory, or otherwise reject it and subsequently take a new one. Contrary to expectations that the number of image rejects should decrease substantially with the introduction of digital imaging, a number of studies have shown that it has not, although the reasons for rejects has changed from exposure errors to positioning and centring errors. Very little research has been on examining how radiographers visually perceive and evaluate the X-ray images in this acceptance/rejection process.