The Arizona Radiation Regulatory Agency (ARRA) inspects x-ray facilities to ensure they are operating properly. Although ARRA has established frequencies for how often it should conduct inspections, it is unable to meet them and has a large backlog of inspections. This backlog was noted in two previous audits dating back 30 years. ARRA should overhaul its inspection approach to ensure it can meet its inspection frequencies and better protect public health and safety. The Medical Radiologic Technology Board of Examiners (MRTBE), a division of ARRA, is responsible for certifying qualified individuals who use sources of radiation, such x-ray machines, investigating complaints against certificate holders, and providing information to the public. However, the MRTBE could better ensure that certificates are issued to only qualified applicants. In addition, the MRTBE also does not always adequately investigate complaints and may inappropriately dismiss complaints. Further, the MRTBE does not always provide accurate and complete information to the public. The MRTBE should improve its processes for issuing certificates, resolving complaints, and providing information to the public.