Plain radiographic examinations were performed on 388 patients (adult and pediatric) using either a calcium tungstate or rare-earth screen. Radiographs were compared for overall image quality, mottle, contrast, density, and detail. The rare-earth screen produced radiographs with significantly more mottle than did the standard screen. However, this was almost never of diagnostic importance. A small but significant decrease in overall image quality also was found with the rare-earth screen. This was the result of minor differences between the grading of optimal and good. A major advantage of rare-earth screens is a 50% or more reduction in radiation exposure. The results here show that rare-earth screens may be used in plain radiographic examinations without a clinically important decrease in image quality.