Objective The aim of this study was to determine the cumulative effective doses (CED) from digital radiographic imaging in very low birth weight infants treated in a tertiary care neonatal intensive care unit (NICU).Study design The CED for each infant was retrospectively calculated using a voxel-based model. The results were compared with previous studies applying conventional radiography.Results Two hundred and six preterm infants were included into this study. Neonates received a median of four radiographs (range: 1-68) and a CED of 50 mu Sv (4-883 mu Sv). Overall mean CED was lower than in previously published data applying conventional radiography. Factors contributing to a lower radiation dose per infant in our study were a lower number of radiographs and smaller field sizes per radiographic image.Conclusions The number of conducted radiographs per patient and the employed field size had a higher impact on the CED than the applied radiographic technology.