The problem of inaccurate roentgen interpretation is complex and not completely understood. Moreover, it would seem that greater emphasis ought to be placed on appropriate physiological and psychological research to better understand this subject. Yet much has been learned about the mechanisms involved in image perception and some practical suggestions are available to in part reduce our observer error. Residency programs ought to include this subject in their overall training scheme so that diagnostic radiologists become aware of the human as well as technical factors present in roentgen interpretation.