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Iatrogenic radiation injuries are an accepted complication of therapeutic radiation therapy, however, they can also occur during fluoroscopic procedures. These are challenging wounds and are often misdiagnosed, leading to frustration for the patient and treating physicians. We reviewed 3 cases of severe fluoroscopic burns with ulceration, non healing wounds, and preoperative debilitating pain. The average number of fluoroscopy procedures was 2.7, with an average total fluoroscopy procedure time of 10 hours. The skin changes presented at 2.3 weeks with the time to surgical intervention being on average 19 months. All patients had immediate resolution of their preoperative pain and a stable healed wound at follow-up. Fluoroscopic radiation burns can be adequately treated with wide excision of all affected tissue and vascularized flap coverage.