Background: Plain X-rays are frequently utilized as diagnostic radiological procedures. However, their usefulness can change based on the situation, such as rib fractures. Moreover, the lack of a uniform procedure in medical facilities, poor image qu

Background: Plain X-rays are frequently utilized as diagnostic radiological procedures. However, their usefulness can change based on the situation, such as rib fractures. Moreover, the lack of a uniform procedure in medical facilities, poor image quality resulting from operator error or insufficient training, financial incentives, and insurance reimbursement regulations can all contribute to an overuse of X-rays. Aim: This study presents the changes in the use of X-rays over the past five years (2019-2023) in the Oman Ministry of Health institutions and identifies interventions that assist in the improvement of the quality of care and patient satisfaction. Methods: The study used a mixed-method design, integrating quantitative (retrospective cross-sectional) and qualitative data collection and analyses. Quantitative data were collected from the Nabdh Al-Shifa and the annual health report over five years. Focus group interviews were used for Qualitative data collection. Results: a positive core relationship exists between population size and use of X-rays, and there were underlying contributing factors for over X-rays. The rate at which X-ray consumption has increased over the last two years has been deemed reasonable based on several variables, such as shifts in clinical practice or population growth. Conclusion: This study demonstrated that patients aged from 0-4 years had the highest X-ray utilisation service rate over the past five years, which raises concerns about the long-term risks associated with repeated radiation exposure. Clinical rotations and appropriate training for physicians at primary health care institutions, and strategies to reduce the significant financial implications, are recommended to address the high rate of X-ray utilisation.