Vascular interventional procedures carried out under fluoroscopic guidance often involve high radiation doses. Above certain thresholds, radiation can cause significant damage to the skin including hair loss and severe necrosis. Such damage has been reported by several investigators. Many attempts have been made to quantitate the radiation doses to the skin involved with these procedures, but dosimetry methods are often flawed. To improve the situation better monitoring of radiation doses, fluoroscopist education, and changes in technology and methods are needed.