The use of x-ray generators for diagnostic radiology in the medical sector in Cameroon, Central Africa, is wide spread and on the increase in recent times. Regulatory control of x-ray machines used in medical sector has been achieved in the Littoral Region of Cameroon by means of notification and authorization systems, routine inspections, and enforcement programs. Quality control of x-ray equipment is performed to test the components of the radiological system and verify that the equipment is operating satisfactorily before issuance of the authorization with a validity of two years. The Licensee has the responsibility to conduct internal QC of their own x-ray equipment to insure their safe use and quality care to patients. After a 2‐y period, the authorization shall be renewed and a new quality control is carried out. Because Cameroon is a developing country, second hand x-ray machines are imported and radiation exposure control is required to ensure protection of workers, patients, and the public by measuring physical parameters of the x-ray generators and imaging devices at the time of commissioning. Forty-five x-ray machines located in the Littoral Region of Cameroon are considered. The authorization/registration program is implemented in the whole country, but the considered x-ray machines were identified because of the high number of medical examinations due to patients and workers to whom the annual routine medical examinations are required by their employers. Is appears by the present study that around 45% of x-ray machines are inappropriate for diagnostic radiology. Based on their state of operation, enforcement measures are taken to maintain them or to prohibit their use. Appropriate training of staff under ionizing radiation is part of the effort to develop the necessary awareness about safety culture. The acquired knowledge and skills ensure the required protection and safety at workplaces.