The purpose of this work was to assess the: (a) impact of regulations on radiation safety and development of radiation safety culture, (b) perceived safety level in the participating facilities, (c) future needs regarding strengthening of regulations, patient dose consideration, and exposure tracking, in different countries around the world. Appropriate questionnaires probing the above-mentioned themes were sent to radiologic professionals working in healthcare facilities. A total of 257 responses from 25 countries were received and analyzed. Average scores for the three different sections/themes of the questionnaire ranged from 64.6% to 74.9%. Higher scores indicated stronger agreement of the survey participants with the theme in question. Statistical comparisons among different professional groups revealed that professionals in developing countries perceived regulations to be significantly more important for improving safety than their counterparts in developed countries did. Radiologic professionals believe that regulation enhances radiation safety and the development of safety culture. However, there is still room for improvement regarding the implementation of regulatory tools. Safety levels were perceived to be satisfactory, and future needs point toward strengthening of regulations regarding patient dose control, patient dose consideration, and patient exposure tracking. The results of this study should be interpreted keeping possible selection bias in view.