The history of New Orleans radiology helps us understand how innovative medical ideas are transmitted and adopted and how the specialty evolved to incorporate these new ideas. As radiology became a required component of medical practice, additional expertise was needed. This resulted in the need for standardized specialized training and the necessity for some form of certification. New Orleans radiologists have always been involved in these American Board of Radiology efforts and also have held leadership positions in other national radiology organizations. The practice of radiology evolved from photographers being employees to physicians becoming members of a unique specialty with practice ownership interests. Radiologists united to form large practice groups and joined professional associations to share technological innovations as well as ensure a culture of professional collegiality. In New Orleans, organizations and events such as the New Orleans Radiology Society, the Spring Roentgen Conference, and the New Orleans Ultrasound Association were organized. Local radiologists who directed these efforts also participated on boards of many national radiologic organizations and helped advance the science of radiology. As the financial complexity and political stresses of radiology practice increased, groups merged, with a resultant decrease in individual autonomy and an increase in radiologist burnout. This has directly and indirectly resulted in many radiologists becoming employees as they were in the early days of New Orleans radiology.