OBJECTIVE: Our purpose was to determine the maximal fetal exposure to radiation by use of thermoluminescent dosimeters when pelvic measurements were performed by standard or modified digital radiography. STUDY DESIGN: Digital radiography of the pelvis was performed according to a standard technique. Lithium fluoride thermoluminescent dosimeters were positioned on the patient's skin to quantitate the maximal amount of radiation exposure to the fetus. The standard technique often included a portion of fetal vertex. The axial view technique was modified to use an angle of inclination of 17 to 29 degrees relative to the vertical axis. RESULTS: Digital radiography was well tolerated and interpretable images were consistently obtained. The maximal dose to the fetal vertex by use of the standard digital axial slice was 465 mrad. By modifying the standard digital technique and using an angle of inclination of 17 to 29 degrees it was possible to obtain an axial section without including any portion of the fetal vertex. This reduced the maximal total dose to the fetal vertex to 55 mrad, which is less than the background radiation exposure to the fetus over a 9-month period from natural sources. CONCLUSION: Data reported indicate that total fetal radiation exposure is minimal after pelvimetry by digital radiography. Incorporating the modification of the angle for the axial slice, as reported here, resulted in a further significant decrease in fetal radiation exposure. (Am J Obstet Gynecol 1996;175:260-9.)