We have studied the use of image intensification in a trauma theatre over a period of 6 months with particular reference to the acquisition of intraoperative image intensifier thermal prints instead of formal radiographs. The quality of the prints and the savings generated have been assessed. During the study period, 476 patients underwent orthopaedic trauma procedures. The image intensifier was used for intraoperative screening in 280 patients. In 278 of these a thermal print was obtained. This was used, instead of formal check radiographs, to plan further management in 210 patients (75%). In 68 patients, the printout was insufficient in its coverage of the operated area, and a check radiograph was also obtained. In no case did the clarity of the thermal image hinder accurate interpretation. We believe that thermal images are a useful substitute for formal postoperative radiographs in many trauma cases, and that, with notable exceptions, their use could decrease costs, reduce patient discomfort and radiation dose and spare overloaded radiology services.