Projection radiography, based on the storage phosphor (SP) imaging medium is a promising but challenging technology. SP plates consist of phosphor particles that are embedded in a polymer binder like film and then coated onto a flexible backing. Image quality is dependent not only on the performance of the plate, but also on the handling of the plate-cassette combination by the user and the reading system itself. The imaging plates included in this study are the 14' X 17' and 10' X 12' standard plates (ST-V) used for general radiography and the high resolution (HR-V) plates used in mammography and for extremity exams. The cassettes or image plate holders correspond to the plate sizes with the 14' X 17' being lead backed. Recorded downtime of the reader due to plate-cassette operation failures, diagnostic image quality affected by plate artifacts, and plate and cassette replacement rates are for a period of twelve months. Records are maintained through a detailed maintenance log, the image reader's internal record for plate use, and the system's internal error log for physical malfunctions. By keeping a detailed log on maintenance and performance of specific system components, communication to the vendor has been timely and effective in solving equipment failures. Plate-cassette maintenance must be an integral part of overall quality control (QC) that includes technologist training, physical plant (clinical environment) changes, and routine evaluation of the operation and performance of CR system components. Quality control combined with equipment improvements have minimized the downtime of the system, image artifacts and replacement rates of plates and cassettes.