Background: Chest radiograph shows the anatomical structures of the thorax and it is one of the most frequently performed radiographic examinations globally. With accurate patient ' s positioning that is devoid of rotation and also putting patient's body morphology into consideration, chest radiograph revealed significant information of most abnormalities associated with the thoracic region. This study is aimed at evaluating the impact of body morphology on rotation in PA radiographs. Materials and methods: A prospective study design was adopted in this study to evaluate the effects of body habitus and body mass index on rotation identified in chest radiographs and was conducted in single centre in Lagos State, Nigeria from September 2018 to February 2019. Ethical approval for this study was obtained from the Institutional Research Review Board of the study centre. The procedure for the study was adequately explained to the subjects and their consents were properly sought. All standard protocols and techniques were adopted to obtain the PA chest radiographs by qualified Radiographer. The obtained information was treated with high level of confidentiality. Variables such as age, sex, Body Mass Index (BMI), body habitus and patterns of rotation were collected using data capture sheet. The obtained data were analyzed using Statistical Package for Social Sciences (SPSS) version 22. Both descriptive statistics (mean, standard deviation, pie chart and bar chart) and inferential (Chi-square) statistics were used for statistical analysis with p-value<0.05 set for level statistical significance. Results: Out of 200 participants, those with normal weight were highest 60 (30%). BMI showed statistically significant relationships with right and left rotations at (p<0.05). Sthenic body habitus was highest 100 (50%). Body habitus showed statistically significant relationships with right and left rotations at (p<0.05).Of the total participants, males were 48.5% (n=97), while females were 103 (51.5%). There was statistically significant relationship between gender and rotation at (X 2 =69.688, df=1 and p=0.000).Out of 98 cases of rotations identified in this study, 54.1% (n=53) were found to the right when compared to rotation to the left, which is 45(45.9%). Chisquare (X 2) test showed that there was statistically significance with these patterns of rotation at (X 2 =156.989, df=1 and p=0.000). Conclusion: Body morphology effect rotation on chest radiographs. Based on this study, we concluded that increment in BMI and body habitus are associated with increment in rotation on chest radiographs. Rotation on chest radiographs is more frequent in females. BMI, body habitus and gender should be considered when assessing a radiograph with rotation.