We compared a new dual-screen, dual-emulsion film system for X-ray mammography with a widely used single-screen, single-emulsion combination for routine contact mammography in 100 patients with a variety of mammographic findings. By using a five-point rating scale (1 = poor, 5 = excellent), four blinded readers found the conventional combination superior in density (by 0.46 points on the rating scale), resolution (by 0.64 points), contrast (by 0.46 points), visibility of calcification (by 0.50 points), visibility of soft-tissue masses (by 0.37 points), and overall quality (by 0.47 points). No difference was seen in the graininess of the films. In our study, the conventional system was consistently found to be slightly better than the dual-screen, dual-emulsion combination. The dual-emulsion mammograms required more careful scrutiny, particularly for detection of faint microcalcifications.