When tooth enamel is exposed to ionizing radiation, radicals are formed that can be detected using Electron Paramagnetic Resonance (EPR) techniques. EPR dosimetry using tooth enamel is based on the (presumed) correlation between the intensity or amplitude of some of the radiation-induced signals with the dose absorbed in the enamel. In the present paper a critical review is given of this widely applied dosimetric method.The first part of the paper is quite fundamental and deals with the main properties of tooth enamel and several of its model systems (e.g., synthetic apatites). Considerable attention is also devoted to the numerous radiation-induced and native EPR signals, and the radicals responsible for them. The relevant EPR detection, identification and spectrum analysing methods are reviewed from a general point of view. Finally, the need for solid state modelling and the linearity of the dose response are investigated.The second part is devoted to the practical implementation of EPR dosimetry using enamel. It concerns the preparation of samples, specific irradiation problems, spectrum acquisition and it is described how the dosimetric signal intensity and dose can be retrieved from the EPR spectra. Special attention is paid to the energy dependence of the EPR response and to sources of uncertainties. Results of and problems encountered in international intercomparisons and epidemiological studies are also dealt with.In the final chapter the future of EPR dosimetry with tooth enamel is analysed.