Understanding the factors that influence Entrance Surface Dose (ESD) in neonatal and adult chest X-ray examinations is crucial for improving radiation safety. This study explores these influences, along with patterns in chest X-ray usage in Bangladesh, highlighting demographic trends, symptoms, and diagnostic outcomes. Conducted in a single hospital in Dhaka, the study assessed radiation doses in 150 adults and 150 neonates. Data collection involved using a 1000 mA X-ray machine for adults (aged 11-80 years) and a portable Medion MI 100 MOVX Mobile X-ray Machine for neonates (aged 1-20 days), with participants chosen through simple random sampling. X-ray exposure parameters (kVp and mAs) were recorded, and ESD (measured in milligrays) was calculated using a formula tailored for adults and neonates. The results showed a higher number of males (57.3%) than females (42.7%) seeking X-rays. The most common symptoms were fever (51.3%), cold and cough (32%), and chest pain (13.3%). Pulmonary inflammatory lesions were observed in 13.3% of cases, with pleural effusion and cardiomegaly present in 8% and 6.7% of patients, respectively, while 72% had normal findings. There was a noticeable link between certain symptoms and diagnoses, such as chest pain correlating with cardiomegaly and fever with pulmonary inflammatory lesions. ESD levels generally increased with age, though there was a slight decrease in the 51-60 age group. These findings provide valuable insights into chest X-ray practices, which could guide better patient care and targeted interventions in Bangladesh.