To evaluate the possible overuse of skull films, 344 patients were studied retrospectively and 252 were sent a questionnaire. During the 12 month study, 47 skull fractures were detected in 596 patients who had skull roentgenograms because of head trauma. 42 patients had intracranial sequellae but no skull fracture. The presence of a skull fracture usually has no bearing on management and may give the physician an unwarranted feeling of security. Reasons for unnecessary examinations include medicolegal considerations, inadequate history provided to the radiologist and insufficient physical examination. If neurologic signs are present, computed tomography is the first choice procedure.