For medium energy x-rays produced with tube voltages from 70 to 280 kV, the absorbed dose to water, D-w, has been determined by means of water calorimetry with relative standard uncertainties ranging from 0.45% to 0.98% at 280 and 70 kV. The results were confirmed by Monte Carlo calculations, in which the ratios of D-w at 5 cm depth in a reference water phantom to the air kerma free in air, K-a, at the same point in space were compared to the corresponding ratios determined experimentally. The general agreement between measurement and calculation was better than 1%. These results confirm earlier investigations in which the absorbed dose to graphite was determined by means of a graphite extrapolation chamber. For the Monte Carlo calculations, an attempt was made to present a complete uncertainty budget, taking into account type B contributions also.