Radiation use in medical imaging, while essential for accurate diagnosis and treatment planning, poses inherent risks that require comprehensive risk management and safety strategies. This review discusses the critical aspects of managing these risks in clinical settings, focusing on patient safety, staff protection, and environmental considerations. A major challenge in medical imaging is balancing the diagnostic benefits of radiation against potential harms, particularly in sensitive populations such as children and pregnant women. Comprehensive risk management involves implementing dose optimization techniques, such as using low-dose imaging protocols and advanced technologies like iterative reconstruction and artificial intelligence (AI) algorithms, which enhance image quality while minimizing exposure. Additionally, ensuring the safety of healthcare staff is paramount. This requires adherence to strict safety protocols, including the use of personal protective equipment (PPE), regular monitoring of radiation levels, and continuous education on safe radiation practices. Institutional policies must also address the proper maintenance and calibration of imaging equipment to prevent unnecessary exposure due to equipment malfunction or improper use. Environmental safety is another critical component, necessitating the safe disposal of radioactive materials and the adoption of energy-efficient technologies to reduce the environmental footprint of medical imaging. Regulatory compliance with international safety standards, such as those set by the International Commission on Radiological Protection (ICRP) and national bodies, is essential for ensuring consistent safety practices across healthcare institutions. Future directions in radiation safety include the integration of digital health technologies to monitor and manage radiation exposure more effectively, and ongoing research into novel imaging techniques that could further reduce radiation risks. Collaboration between healthcare providers, researchers, and policymakers is crucial to advancing safety standards and improving risk management strategies in medical imaging. This review highlights the importance of a comprehensive approach to managing radiation risks in medical imaging, emphasizing the need for continuous innovation, education, and policy support to protect patients, healthcare workers, and the environment.