IntroductionMedical imaging in healthcare plays a vital role in the assessment, confirmation, and documentation of the course of many diseases and injuries. However, literature reports that the urban population in Sub-Saharan Africa have more access to imaging services than the rural population. This imbalance can affect radiographers working in rural areas. The aim of this study was to explore factors affecting the ability of radiographers to deliver imaging services in rural parts of Zambia. MethodsThis study employed a qualitative exploratory research design. Semi-structured interviews were used to collect data from a stratified and purposive sample of six rural radiographers and three stakeholders [Ministry of Health (MOH), Radiological Society of Zambia (RSZ), and Schools of Radiography] across the country. Data were audio-recorded, transcribed, and subjected to manual thematic analysis. ResultsFour themes emerged following thematic analysis: procurement processes and resources, imaging equipment, job satisfaction, and education and training. Factors, such as donated equipment, the introduction of new imaging services and continuous professional development (CPD) were positive elements that assisted rural radiographers in the delivery of imaging services. However, an unequal distribution of equipment between urban and rural areas, old and obsolete equipment, lack of maintenance and servicing, lack of postgraduate courses, bureaucratic procurement processes, lack of consumables, workload, and low salaries, negatively affected the ability of rural radiographers. ConclusionLack of maintenance and servicing of equipment, as well as bureaucratic procurement processes were the main challenges identified by radiographers to imaging services in rural Zambia. There is a need to decentralise the procurement processes and establish a culture of regular maintenance and servicing of equipment. Implications for practiceThis research highlights the importance of supporting rural radiographers in the delivery of imaging services.