Chest radiography is the most frequently performed radiologic imaging study and also one of the most challenging. The technical aspects of the conventional chest radiographic examination have been studied extensively, and the effects of various parameters on the quality of chest radiographs have been described. However, new approaches to image acquisition and display have been introduced in the last decade, and many circumvent the limitations of conventional screen-film studies. Thus, a number of practical issues must be considered in the selection of chest radiographic equipment for modern clinical practice. In this review, we describe several recent advances in both conventional and digital technologies that can improve the diagnostic quality of chest radiographs.