Finishing a radiography program is a major achievement, and the ARRT Radiography exam is the last big hurdle between you and the R.T.(R)(ARRT) credential. With 230 questions and nearly four hours of testing, “the registry” can feel overwhelming, especially as you wrap up clinicals. The good news is that the American Registry of Radiologic Technologists (ARRT) publishes exactly what the exam covers, including how many questions are scored in each section.

In this guide, we’ll walk you through the exam format, both content outlines you need to know about (the current one and the version that starts March 1, 2027), what each section tests, the official resources worth downloading, and the questions candidates ask most often.

What Is the ARRT Radiography Exam?

The ARRT Radiography exam certifies and registers entry-level radiologic technologists in the United States. When you pass it and meet ARRT’s education and ethics requirements, you earn the right to use the credential R.T.(R)(ARRT). Many states also use ARRT exam results as part of their licensing process for radiographers.

The exam tests the knowledge an entry-level technologist uses daily: caring for patients, protecting everyone from unnecessary radiation, producing diagnostic images, and positioning for a wide range of procedures. Most questions are multiple-choice with one best answer, and many are based on realistic clinical situations rather than simple definitions.

What Is the ARRT Radiography Exam Format?

Here is the exam at a glance, based on the ARRT Primary Eligibility Pathway Handbook (2026) and ARRT’s exam pages:

  • Questions: 230 total, including 200 scored questions and 30 unscored pilot questions. Pilot items are mixed in at random and look exactly like scored items, so treat every question as if it counts.
  • Time: 230 minutes of testing time. The full appointment is 250 minutes and includes a short tutorial, a nondisclosure agreement, and a post-exam survey.
  • Question types: Mostly multiple-choice questions with one best answer. The tutorial lets you practice with the question formats before your exam clock starts.
  • Delivery: Computer-based testing at Pearson VUE test centers.
  • Scoring: Scaled scores from 1 to 99. You need a total scaled score of 75 to pass. That’s not 75% correct.
  • Results: You see a preliminary score at the test center, but it isn’t final. ARRT typically posts official results to your account within about 10 business days.

With 230 minutes for 230 questions, you have about one minute per question. Positioning and patient care items often go quickly, which banks time for physics calculations and image evaluation questions.

Which Content Outline Applies to Your Exam?

ARRT calls its content outline the Examination Content Specifications, and it currently lists two versions for Radiography:

Your test date decides which version you get. If you graduate this winter and test in January or February 2027, study the 2022 outline. If your exam falls in March 2027 or later, use the 2027 version. Either way, both have 200 scored questions in the same four categories. The differences are in how those questions are distributed:

  • Patient Care: 33 items (2022) → 31 items (2027)
  • Safety: 50 items (2022) → 46 items (2027)
  • Image Production: 51 items (2022) → 51 items (2027)
  • Procedures: 66 items (2022) → 72 items (2027)

ARRT’s announcement of the update also notes several content changes for 2027: computed radiography (CR) content is removed, virtual grids are added, compensating filters are removed, informatics now includes security, confidentiality, and teleradiology, and intravenous urography is removed from GU studies. The sections below use the 2022 counts, with 2027 counts in parentheses.

Patient Care: 33 Items (31 in 2027)

This category has one subcategory, Patient Interactions and Management. It covers what you do for and with the patient before, during, and after the exam.

  • Ethical and legal issues, such as informed consent, HIPAA, advance directives and DNR orders, patient identification, and terms like negligence, battery, and malpractice.
  • Communication across language, cultural, age, and impairment barriers, plus pre- and post-exam patient education.
  • Body mechanics and transfers (transfer boards, mechanical lifts, gait belts) and working around oxygen, IV pumps, and urinary, nasogastric, and tracheostomy tubes.
  • Vital signs, fall prevention, and responding to emergencies such as cardiac or respiratory arrest, seizures, diabetic reactions, and allergic reactions.

What questions look like: A patient becomes diaphoretic and confused partway through an exam. You’ll need to recognize a likely cause, such as hypoglycemia, and choose the right first action.

Safety: 50 Items (46 in 2027)

Safety splits into Radiation Physics and Radiobiology (21 items in both versions) and Radiation Protection (29 items, dropping to 25 in 2027).

  • X-ray production, target interactions (bremsstrahlung and characteristic), beam quality and quantity, the inverse square law, and photon interactions such as the photoelectric effect and Compton scatter.
  • Radiobiology: units of measure, radiosensitivity, LET and RBE, deterministic vs. stochastic effects, fetal effects, and acute radiation syndromes.
  • Minimizing patient dose through beam restriction, exposure factors, filtration, and fluoroscopy controls.
  • Personnel protection (time, distance, shielding), protective apparel, dosimeters, and occupational and public dose limits.

Study tip: Learn the radiobiology terms in pairs (somatic vs. genetic, deterministic vs. stochastic, early vs. late effects). Many questions test whether you can tell the partners apart.

Image Production: 51 Items (51 in 2027)

Image Production splits into Image Acquisition and Evaluation (26 items) and Equipment Operation and Quality Assurance (25 items). It’s the most technical category on the exam.

  • Factors affecting image quality: mAs, kVp, SID, OID, focal spot size, grids, filtration, the anode heel effect, and motion.
  • Technique charts, automatic exposure control (AEC), and technique adjustments for casts, pathology, and body habitus.
  • Digital image characteristics, including pixel and detector element size, matrix, bit depth, detective quantum efficiency (DQE), dynamic range, and signal-to-noise ratio.
  • Generators, X-ray tube construction, image processing, PACS and DICOM, and quality control tests.

What questions look like: An image shows quantum mottle with a low exposure indicator. You’ll decide what caused it and which single change fixes it without excess dose.

Procedures: 66 Items (72 in 2027)

Procedures is the largest category, and it grows in 2027. It splits into Head, Spine, and Pelvis (18 items; 20 in 2027), Thorax and Abdomen (20; 22), and Extremity (28; 30).

  • Positioning, anatomy, and related pathology for the skull, facial bones, sinuses, spine, pelvis, and hips.
  • Chest, ribs, sternum, abdomen, and contrast studies such as upper GI series, small bowel series, contrast enemas, cystography, and hysterosalpingography.
  • Upper and lower extremities, plus bone surveys, bone age studies, and arthrography.
  • Adapting procedures for trauma, age, limited mobility, and body habitus, and evaluating whether the image shows the required anatomy.

Study tip: Questions rarely ask, “What is the central ray for a PA chest?” More often they show a positioning error and ask what to correct, such as rotation on a lateral knee or a foreshortened scaphoid.

How Should You Use the ARRT Blueprint to Build a Study Plan?

  1. Confirm your outline. Check your exam window. If you’ll test on or after March 1, 2027, download the 2027 specifications and note what was added and removed.
  2. Take a baseline. Answer a mixed set of practice questions before you review so you know where you really stand.
  3. Weight your time. Procedures and Image Production together account for 117 of 200 scored items (123 under the 2027 outline). Give them the most hours, but don’t neglect Safety.
  4. Use the attachments. The specifications include a list of the specific positions and projections that can be tested. Turn it into a checklist.
  5. Map every miss. Tag each missed question with its subcategory. Your ARRT score report uses the same eight subcategories, so practicing this way mirrors how you’ll be scored.
  6. Finish with timed, mixed practice. Build up to sessions where one question per minute feels normal.

What Official Resources Should You Use?

Commonly used ARRT RAD study textbooks:

  • Fauber’s Radiographic Imaging and Exposure, 7th Edition (ISBN 978-0443114502)
  • Radiologic Science for Technologists: Physics, Biology, and Protection, 12th Edition (ISBN 978-0323661348)
  • Radiography Essentials for Limited Scope, 7th Edition (ISBN 978-0443106156)
  • Radiation Safety and Radiobiology In Medical Imaging, 10th Edition (ISBN 978-0443123535)

Frequently Asked Questions About the ARRT Radiography Exam

What score do I need to pass the ARRT RAD exam?
A total scaled score of 75 on ARRT’s 1 to 99 scale. Because exam versions vary slightly in difficulty, the number of correct answers needed can shift a little. ARRT’s 2025 Annual Exam Report lists approximately 67% correct as the level needed to pass Radiography.

What is the ARRT RAD exam first-time pass rate?
According to the same report, 85.8% of first-time Radiography candidates passed in 2025, up slightly from 85.2% in 2024.

How many times can I take the ARRT RAD exam?
You get three attempts within three years, starting from the day your first exam window opens. Each attempt requires a new application and fee. If you run out of attempts or time, you must complete an ARRT-recognized educational program again to regain eligibility.

How long do I have to schedule the ARRT RAD exam?
After ARRT processes your application, you receive a 365-day exam window to schedule and take the exam with Pearson VUE.

When do I get my official ARRT RAD exam results?
Usually within about 10 business days. ARRT emails you when they’re posted to your account, and it doesn’t give scores by phone.

Start Preparing for the ARRT Radiography Exam With Pocket Prep

Pocket Prep’s ARRT RAD practice questions give you 500 exam-style questions across every content category, each with a detailed explanation that teaches the “why” behind the best answer. Use Build Your Own Quiz to work through one subcategory at a time, then switch to Timed Quiz to get comfortable with the one-minute pace.

You’ve already done the hard work in your program, and with consistent studying, you can walk into the test center with confidence.