The charts and routine preoperative roentgenograms of 350 children admitted for elective pediatric surgery were analyzed to evaluate the clinical importance of routine preoperative chest roentgenograms. This analysis, and a review of the literature, should indicate that routine preoperative roentgenograms for elective pediatric surgery are unnecessary. Indications for selected preoperative roentgenograms based on patients' history and clinical findings are enumerated.