As technological advances have allowed for improved access to valuable tests, medical imaging radiation (MIR) has become a leading source of ionizing radiation exposure. The news media have covered MIR with increasing regularity and, at times, in an alarming manner. The current context has spurred some health professionals to consider the needs of the patient in terms of creating an informed and balanced dialogue surrounding medical decisions involving MIR. With a patient-centered approach, clinicians strive to inform and collaborate with patients to explain benefits and address concerns about risk. Clinicians and researchers have debated the aims, methods, and futures of these efforts with some controversy. To provide context for this debate, the current article reviews the literature on how patients perceive MIR and patient-centered dialogues about its benefits and risks. The authors discuss research on patient perspectives of MIR, including public knowledge, attitudes, beliefs, and preferences. Then, the authors describe empirically tested interventions to address some of these needs. Through the lens of the patient’s perspective, the authors acknowledge gaps in the literature and advocate for future research.