The hazards of exposure to ionising radiation are well documented. Fears have been raised that occupational exposure to ionising radiation by orthopaedic surgeons may have detrimental effects on the future health of their unborn offspring. The current members of the British Orthopaedic Trainees' Association and orthopaedic consultants appointed during the last 5 years in the United Kingdom were contacted using a postal questionnaire. Obstetricians and gynaecologists of a similar age group were also contacted to act as the control group. The collected data were compared with the latest national data as published by the Office of Population Censuses and Surveys for England and Wales (OPCS, 1991). In all, 504 questionnaires were posted to orthopaedic surgeons and 1597 to obstetricians and gynaecologists. Reply rates were 334 (66%) and 986 (62%), respectively. Our data reveal a higher rate of congenital abnormalities as compared with the normal population in both groups (P < 0.001). However, there were no statistically significant differences in the rate of congenital abnormalities between the offspring of orthopaedic surgeons and obstetricians and gynaecologists (P = 0.78). These findings suggest that the increased rate of congenital abnormalities observed in both groups is more likely to be associated with factors other than exposure to X-rays. In this study, male surgeons had a higher incidence of female children compared with the normal population (P = 0.01). The incidence of childhood malignancies does not appear to be raised in either group. These findings suggest that the current levels of occupational exposure to X-rays by orthopaedic surgeons is unlikely to be associated with an increased risk of congenital abnormalities or childhood malignancies in their children.