Safe C-arm use depends on two aims: optimizing the radiation dose that the patient receives and minimizing the radiation dose that the equipment operators and surgical staff are exposed to. You want to generate the least radiation necessary to obtain usable images. This thinking is summed up in the acronym "ALARA," or "as low as reasonably achievable," a sort of cost-benefit philosophy for radiation safety. Here are five principles toward reaching the goal of safe C-arm use for your orthopedic, pain management, urological or other procedures.