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Skyrocketing health care costs and pressures from managed care have combined to promote cost-cutting strategies in radiology and radiation oncology departments. A study was conducted to evaluate the use of a high-resolution laser printer for printing plain-paper images as substitutes for both original and duplicate radiologic film images. A variety of radiologic images were used to evaluate the image reproduction capabilities of the printer in terms of linearity, detail, and contrast. In many cases, printed images had a quality comparable to that of the original images. Six computed tomographic (CT) scans and six radiation therapy simulator radiographs were compared with printed reproductions by each of seven board-certified radiation oncologists, who rated the reproductions as acceptable for documentation, acceptable for diagnostic purposes (CT scans only), or unacceptable. Ninety-five percent of printed CT images and 90% of printed simulation images were rated acceptable for documentation. The quality of printed images of radiation therapy port films was not quantitatively measured but was improved by adjusting image contrast and brightness and using various image enhancement techniques. The use of printed images is less expensive than that of processed film and eliminates the environmental, time, storage, and delivery problems associated with film. Technologic advances in imaging, networking, and printing have made possible the inexpensive duplication of medical images.