Technologies and performance of digital projection radiography are reviewed. Storage phosphor imaging plates can be used in existing diagnostic equipment and the resulting digital images permit the recognition of fine interstitial changes, if a high frequency edge enhancement is performed. While a generalized enhancement of low and medium spatial frequencies and a grey scale reversal do not improve the detectability of pulmonary nodules, selective enhancement of low frequencies in the mediastinal and retro-diaphragmatic areas may well improve diagnostic performance. Dose can be reduced if the resulting signal-to-noise ratio is adequate for diagnosis. Further dose savings can be achieved by the reduced number of retakes. Dual energy techniques improve the detectability and differential diagnosis of pulmonary nodules. The further development of picture archiving and communication systems (PACS) will turn the digital projection radiography into the method of choice for the diagnosis of chest disease.