The aim of our study was to evaluate differences between males and females based on patterns of costal cartilage ossification and also with respect to ageing. We provided diagnosis of ossifications from two files of radiograms. The first group consisted of 1044 chest and abdominal radiograms of patients (537 men and 507 women), ranging in age from 10 to 95 years obtained by using conventional X-ray technique. The second group was a set of 55 radiograms of chest plate fragments of cadavers (29 men and 26 women) aged from 15 to 98, obtained by using soft X-ray imaging in the skiagraphic-skiascopic unit. Ossifications were identified in more than 80% of the cases. They appear in puberta and their occurrence increases with age. The peripheral ossification pattern, typically the male pattern, is characterized by subperichondral deposits which contour the upper and lower margin of cartilage. The female, central lingual ossification pattern, is characterized by the pyramidal (lingual) shape of ossifications with a peak towards the sternum. The existence of another typical female central globular model of ossification was not confirmed in the file of cadavers. Central globular foci were found in both sexes (62% of women and 34% of men) from the 3rd decade. In the sample of Caucasian men and women (Czech population) we detected a frequent occurrence of costal cartilage ossification. Peripheral and central lingual patterns are highly predictive for sex determination. Globular loci of ossifications can be used for age estimation.