X-ray table mattresses should not reduce image quality (IQ), or misdiagnosis may occur. Equally, X-ray table mattresses should not overly attenuate radiation, or patient dose may have to increase in order to produce an image of suitable quality. A review of the literature indicated no study had investigated the influence of x-ray table mattresses on IQ and radiation dose. This work investigates seven x-ray table mattress, that are used in practice, for their impact on IQ and radiation dose.