Ignorance of the harmful effects of x rays resulted in the absence of standard radiation safety procedures which are employed today. Scientists and physicians would often place their hands directly in the x-ray beam resulting in radiation burns. Trivial uses for the technology also resulted, including the Shoe-Fitting Fluoroscope used by shoe stores in the 1930s-1950s.

Due to the limited light produced from the fluorescent screens, early radiologists were required to sit in a darkened room, in which the procedure was to be performed, accustomizing their eyes to the dark and thereby increasing their sensitivity to the light. The placement of the radiologist behind the screen resulted in significant radiation doses to the radiologist. Red adaptation goggles were developed by Wilhelm Trendleenburg in 1916 to address the problem of dark adaptation of the eyes, previously studied by Antoine Beclere. The resulting red light from the goggles' filtration correctly sensitized the physician's eyes prior to the procedure while still allowing him to receive enough light to function normally.

The development of the image intensifier and the television camera in the 1950s revolutionized fluoroscopy. The red adaptation goggles became obsolete as image intensifiers allowed the light produced by the fluorescent screen to be amplified, allowing it to be seen even in a lighted room. The addition of the camera enabled viewing of the image on a monitor, allowing a radiologist to view the images in a separate room away from the risk of radiation exposure.

More modern improvements in screen phosphors, image intensifiers and even flat panel detectors have allowed for increased image quality while minimizing the radiation dose to the patient. Modern fluoroscopes use CsI screens and produce noise-limited images, ensuring that the minimal radiation dose results while still obtaining images of acceptable quality.