Overutilization of radiological studies has become a significant economic consideration in this country. The reasons for unnecessary examinations include indirect financial benefit to physicians, medicolegal considerations, inadequate history provided to the radiologist, and simply inappropriate requests. In many radiological examinations, the indications are controversial or unknown. Recent Professional Standards Review Organization legislation will probably diminish overutilization of radiological studies, both directly through peer review and indirectly by providing comparison statistical data to facilitate better assessment of the value of individual examinations. The final common pathway of the radiological examination is the radiologist, who has the right and the duty to refuse studies, particularly when they involve risk to the patient.