PURPOSE: The pnuemoconiotic findings on chest radiograph for pneumoconiosis are affected by the technique, the equipment and the reading environment. We report here on the results of evaluating the thoracic radiology of the Medical Institutions for Pneumoconiosis (MIPs). MATERIALS AND METHODS: For the first time, we visited the MIPs to evaluate the thoracic radiography that is used to treat patients with pneumoconiotic complications, and this included evaluating the equipment and the technical parameters for thoracic radiography, the computed tomography, the education for quality assurance health care and the reading environment. We used the guideline published by the Occupational Safety and Health Research Institute (OSHRI). Ten images were randomly picked from the MIPs for evaluating the image quality, and then these were rated by two experienced chest radiologists for pneumoconiosis according to thecriteria of the OSHRI. RESULTS: Of the 33 institutions, the failed group (mean<60) scored 36.4% for radiological technique (RT),30.3% for image quality (IQ) and 21.2% for the reading environment (RE). There were statistically significantly differences between the passed and failed groups for RT (75.8 +/- 9.1 vs. 40.8 +/- 13.6, p<0.001), for IQ (68.3 +/- 5.8 vs. 47.8 +/- 9.4, p<0.001) and for RE (78.3 +/- 15.8 vs. 18.3 +/- 21.9, p<0.001). The group that received education was significantly higher for the RT (68.7 vs. 53.2, p=0.032), the IQ (65.3 vs. 56.6, p=0.039) and the RE(76.2 vs. 47.0, p=0.005) than that for the group that didn't receive education. CONCLUSION: The MIPs need surveillance and education for improving the quality assurance health care in thoracic radiography for treating patients with pneumoconiosis and who have complications.