Loose seed placement in permanent prostate brachytherapy (PPB) is associated with seed migration to the lung and other locations in the body whereas seed placement with stranded seeds is associated with reduced seed migration. However, some reports indicate that seed displacement of stranded seed trains in and around the prostate may occur such that prostate dosimetry is adversely affected. The purpose of this study is to examine a large series of sequential plain 2D images to determine if obvious and substantial seed displacement occurs. Between 10/2010 and 5/2014 a series of 102 patients underwent PPB at our institution who had routine post-implant fluoroscopy (PIF), Day 0 post-implant dosimetry (PID) and gold marker placement near the prostate base and apex. Since 2004, 686 patients have undergone implant with stranded seeds only and in 2011, a general policy of including pelvic in addition to chest x-rays at four month follow up visits was implemented by one of the brachytherapists. Implants routinely included seed placement in the base and apex with separate seed trains of only two or three seeds in length as opposed to seed trains traversing the entire length of the prostate. Apical seed placement was at or typically within 8 mm of the apex. In order to determine if any seed displacement occurred a comparison of the PIF taken at day zero and standing pelvic image four months later using the gold seed length of 3 mm as the reference length. Measurements and observations include: 1) an X-axis measurement (horizontal) measuring the distances between the two furthest seeds in that direction. 2) Y-axis measurement (vertical) with seeds measurement including distance between gold seeds, superior seed and inferior seed from the gold seed placement. A total of 102 cases were available for analysis. The Y-axis distance of day 0 Fluoroscopy images (range:38mm-81mm), and four month standing pelvic x-ray (range: 34mm-106mm). The mean for Day 0 Y-axis distance was 54mm and the mean for the 4 month Y-axis distance was 52mm. The X-axis distance of day 0 Fluoroscopy image was (range 33mm-66mm), and the four month standing x-ray image (range: 45mm-76mm). The mean for Day 0 X-axis distance was 51mm and for the 4 month mean X-axis distance was 59mm. One patient lost 10 seeds through apparent seed migration through the bladder and urethra with no apparent adverse clinical consequences. Four patients had significant local migration of 1 or 2 seeds from the prostate, 3 moved superior to the prostate and 1 inferior to the prostate. 3 patients also had migration of seeds to the chest. Despite the limitations evident in method employed in this study comparing two disparate plain imaging techniques (PIF vs pelvic x-ray) with different source to subject distance, and patients in different positions (extended dorsal lithotomy and standing), some general observations are possible: 1) no repetitive or systematic loss of seeds through the bladder or urethra occurred, 2) no seed displacement in the caudal direction appeared routinely, 3) technique-related factors may explain the finding in this study as compared to prior reports, and 4) sequential CT or MR-based dosimetry is necessary in order to further substantiate these findings.