What’s on the ARRT Radiography Exam? 200 Scored Questions in 4 Categories (2026)
The American Registry of Radiologic Technologists (ARRT) Radiography examination, the exam for the R.T.(R) credential, has 200 scored multiple choice questions plus 30 unscored pilot questions, 230 items in all, with 230 minutes of testing time inside a 250 minute appointment, as of October 2026. Scored questions fall into four content categories under the specifications in effect through February 28, 2027: Procedures with 66 questions (33%), Image Production with 51 (25.5%), Safety with 50 (25%), and Patient Care with 33 (16.5%). ARRT’s board approved new specifications in January 2026 that take effect March 1, 2027 and shift the counts to Procedures 72, Safety 46, Patient Care 31, with Image Production unchanged at 51. A total scaled score of 75 on ARRT’s 1 to 99 scale is required to pass. The application fee is $225 as of October 2026, and you have three attempts within three years of your first exam window opening. This guide walks through each category, charts the weights, flags the 2027 change, and includes an original sample question.
The Four Content Categories, Ranked by Weight
ARRT publishes the number of scored questions in each category, and the percentages below are those counts divided by 200. Procedures carries a third of the exam on its own. Patient Care is the smallest category, but at 33 questions it is still too large to treat as a side topic. These counts apply to candidates testing through February 28, 2027, per ARRT’s content specifications board approved in January 2021.
Procedures: 33% (66 Scored Questions)
This is the positioning half of the exam, split into three subcategories: Head, Spine and Pelvis Procedures (18 questions), Thorax and Abdomen Procedures (20), and Extremity Procedures (28). Extremities alone outweigh the other two subcategories individually, so upper and lower limb projections deserve steady review. Across all three, ARRT’s outline organizes the knowledge into four threads: positioning, related anatomy, adapting a procedure to the patient, and evaluating the displayed anatomy on a finished image. Adapting covers factors such as body habitus, trauma, and age. Expect questions that ask what a correct image should show, and what to change when it does not. The Thorax and Abdomen group includes chest, abdomen, and gastrointestinal studies, and the Head, Spine and Pelvis group includes skull, facial bones, sinuses, the spine, the pelvis, and genitourinary studies.
Image Production: 25.5% (51 Scored Questions)
Image Production is split almost evenly: Image Acquisition and Evaluation has 26 questions and Equipment Operation and Quality Assurance has 25. The first half covers the factors that shape radiographic quality, technique charts, automatic exposure control, and the characteristics of digital images. The second half covers imaging equipment, image processing and display, and quality control testing. This category rewards cause and effect reasoning: if one technical factor changes, what happens to exposure at the receptor, contrast, noise, and spatial resolution. Memorizing definitions without practicing the direction of each change is the usual gap here.
Safety: 25% (50 Scored Questions)
Safety has two subcategories: Radiation Physics and Radiobiology (21 questions) and Radiation Protection (29). Physics and radiobiology cover how x-rays are produced and interact with matter, plus the biological effects of radiation. Radiation protection covers minimizing patient exposure and protecting personnel under the ALARA principle. ARRT notes that SI units are the primary units of radiation measurement on the exam, so practice with SI units rather than the older traditional units.
Patient Care: 16.5% (33 Scored Questions)
Patient Care is a single subcategory, Patient Interactions and Management, with 33 questions. The outline spans ethical and legal aspects (including the ARRT Standards of Ethics), interpersonal communication, physical assistance and monitoring, medical emergencies, infection control, handling and disposal of hazardous materials, and medications and contrast media. The contrast media topics include administration routes, types and properties, appropriateness for a given examination, and recognizing and responding to reactions. Many of these questions are scenario based: a patient situation, then the correct next action.
What Changes on March 1, 2027
ARRT lists two Radiography specifications on its examination content specifications page, as of October 2026: the 2022 version, which applies through February 28, 2027, and a 2027 version effective March 1, 2027. The 2027 document carries a board approval date of January 2026. The exam stays at 200 scored and 30 pilot questions, but the scored counts move between categories.
| Subcategory | Through Feb 28, 2027 | From Mar 1, 2027 |
|---|---|---|
| Patient Interactions and Management | 33 | 31 |
| Radiation Physics and Radiobiology | 21 | 21 |
| Radiation Protection | 29 | 25 |
| Image Acquisition and Evaluation | 26 | 26 |
| Equipment Operation and Quality Assurance | 25 | 25 |
| Head, Spine and Pelvis Procedures | 18 | 20 |
| Thorax and Abdomen Procedures | 20 | 22 |
| Extremity Procedures | 28 | 30 |
| Total scored | 200 | 200 |
Per ARRT’s 2022 and 2027 Radiography content specifications, as of October 2026.
The net shift is six more Procedures questions (66 to 72) and fewer questions in Safety and Patient Care. Under the 2027 counts, Procedures becomes 36% of scored content, Safety 23%, Image Production 25.5%, and Patient Care 15.5%. ARRT also approved an updated passing standard for Radiography that takes effect March 1, 2027, and says the purpose of the update is not to raise or lower pass rates. Your testing date, not your study start date, decides which version applies, so check which side of March 1, 2027 your appointment falls on. For the full list of content shifts, see our guide to the ARRT 2027 exam changes.
Sample Question: Image Production
This original practice item shows the cause and effect style described above. It is not taken from any ARRT material.
Exam Format, Fees, and Eligibility
ARRT’s 2026 Primary Eligibility Pathway Handbook describes the exam as computer based and administered at Pearson test centers, and it does not describe a remote option. The 250 minute appointment is 8 minutes of tutorial, 2 minutes for the nondisclosure agreement, 230 minutes of testing, and a 10 minute survey. ARRT advises allowing about one minute per question, pilot items are not identified, and your score counts correct answers, so answer every question. At the end you see a preliminary score only. The final score report arrives by email after ARRT completes its analysis.
The application fee is $225 as of October 2026, and ARRT lists $200 for each reapplication after a first or second unsuccessful attempt. To establish eligibility you complete an ARRT verified educational program, hold an associate degree or higher from an accredited institution, meet the ethics requirements, and apply through your ARRT account.
Frequently Asked Questions
How many questions are on the ARRT Radiography exam?
There are 200 scored questions plus 30 unscored pilot questions, 230 items in total, as of October 2026. Pilot questions are not identified and do not affect your score.
What are the ARRT Radiography exam categories?
Patient Care, Safety, Image Production, and Procedures. Through February 28, 2027 they carry 33, 50, 51, and 66 scored questions. From March 1, 2027 they carry 31, 46, 51, and 72.
How long is the ARRT Radiography exam?
Testing time is 230 minutes within a 250 minute appointment that also includes an 8 minute tutorial, a 2 minute nondisclosure agreement, and a 10 minute survey, per ARRT’s 2026 handbook.
What score do I need to pass?
A total scaled score of 75 on a 1 to 99 scale. Scaled scores are not percent correct; ARRT’s 2025 annual exam report lists roughly 67% correct as the approximate level needed to pass.
Ready to see how your preparation matches these weights? Try a free ARRT Radiography practice test to find your weak categories, or start practicing now with full length practice built around the four content categories.
Sources
- ARRT, Examination Content Specifications (2022 and 2027 Radiography versions)
- ARRT, 2026 Primary Eligibility Pathway Handbook (exam format, eligibility, attempts)
- ARRT, Fees
- ARRT, Exam Statistics (2025 Annual Exam Report)
- ARRT, Updated Radiography passing standard (August 27, 2026)
- ARRT, Radiography credential page
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For educational and exam preparation purposes only. Not a substitute for formal clinical training.
