Objective: To clarify the effects of ionizing radiation and to dispel fear associated with the use of radio-activity in medical diagnosis and therapy. Design: Studies of populations in geographic areas of increased cosmic radiation and high natural background radiation, radiation-exposed workers, patients with medical exposure to radioactivity, and accidental exposure are reviewed. Results: No reproducible evidence shows harmful effects associated with increases in background radiation of 3 to 10 times the usual levels. American military personnel who participated in nuclear testing had no increase in leukemia or other cancers. Among 22,000 patients with hyperthyroidism treated with I-131 (mean dose, 10 rem), no increased incidence of leukemia was found in comparison with 14,000 similar patients who received other treatment. A 20-year follow-up of 35,000 patients who underwent I-131 uptake tests for evaluation of thyroid function revealed that those studied for other than a suspected tumor had only 60% of the thyroid cancers expected in a control group. Although early studies showed that high exposures of miners to radon and its daughters resulted in a substantial increase in lung cancer, no evidence exists for an increase in lung cancer among nonsmokers exposed to increased radon levels in the home. Conclusion: Perhaps the association of radiation with the atomic bomb has created a climate of fear about the possible dangers of radiation at any level; however, no evidence indicates that current radiation exposures associated with medical usage are harmful.