For the past 100 years, the paradigm for radiography has been premised on absorption as the sole means of contrast formation and on ray optics as the basis for image interpretation. A new conceptual approach to radiography has been developed that includes phase (ie, refractive) contrast and requires wave optics for proper treatment. This new approach greatly increases the amount of information that can be obtained with radiographic techniques and is particularly well suited to the imaging of soft tissue and of very small features in biologic samples. A key feature of the present technique of phase-contrast radiography is the use of a microfocus x-ray source about an order of magnitude (< or = 20 microm) smaller than that used in conventional radiography. Phase-contrast radiography offers a number of improvements over conventional radiography in a clinical setting, especially in soft-tissue imaging. These improvements include increased contrast resulting in improved visualization of anatomic detail, reduced absorbed dose to the patient, inherent image magnification and high spatial resolution, use of harder x rays, and relative ease of implementation. More technologically advanced detectors are currently being developed and commercialized, which will help fully realize the considerable potential of phase-contrast imaging.