The aim of this study was to highlight the referrals for x-rays from an Emergency Department of a tertiary care hospital. A retrospective review of files was done for patients visited Emergency department (ED) of Alnoor Specialist Hospital, Makkah, Saudi Arabia, during the month of April, 2006G. The total of 660 subjects was exposed to 1472 x-rays. Majority 288 (43.3%) were below 24 years of age. Six hundred and twenty (93.9%) patients got exposures rang of 1-4 while only four (0.6%) got more than eight exposures to x -rays. Lower limb was exposed 384times (26%), followed by chest 320 (21.7%). Overall 240 (16.3%) x-rays had positive findings with majority of upper limb 60 (50%) followed by chest 72 (22.5%). Pelvis & perineum had no positive x-ray. Eighty four percent x-rays had no positive findings. Majority of x-rays were done for lower limb. Neck, pelvis & perineum x-rays had no positive findings.