The management of radiographic film is based on a centralized, sequential management strategy using individual patient film jackets as an archiving medium. This centralized manual management strategy has evolved because x-ray film has been the sole record of a patient's image information. However, the operation of any film file room always faces significant problems. Storage space for patient film jackets is rarely adequate. The demand for patient film jackets is great particularly during the first part of a patient's hospitalization. The access and utilization of the film jacket by multiple clinicians and hospital services can rarely be adequately met, Film jackets are often unavailable due to misfiling or capture in private collections of interesting cases. Ultimately, the successful operation of any film file room depends on the dedication and training of an adequate number of film file room staff, the cooperation of the clinical users and strict enforcement of check-in--check-out protocols.