Background To assess awareness of ionizing radiation safety measures among Egyptian Urology Trainees and Urologists and see the effect of radiation safety courses on the adoption of these measures. Methods This Internet-based survey was conducted via https://www.surveymonkey.com/ after approval by the Egyptian Urological Association (EUA). It was sent to all EUA members via email during December 2019. Participation was voluntary and questions included participants' demographics such as age,

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... er, years of experience, level of training and type of practice. Other questions assessed some domains such as whether the participant had radiation safety courses, and the extent to which she/he is adopting these measures during daily practice. Results A total of 142 Egyptian urology trainees and urologists responded to this electronic survey. The mean hours of fluoroscopy-guided endourologic procedures per week were 4.3 ± 2.1 h, and only 23% reported that they always wear protective lead aprons. In terms of the thyroid shield, X-ray protective gloves, eye googles, a total of 70% and 89% and 89% reported that they never wore it, respectively. The ALARA principle was known by only 24% of respondents. About 94% denied receiving any radiation safety courses. Participants who received radiation safety course reported significantly shorter FT during URS (p = 0.04), PCNL (p = 0.03) and JJ insertion (p = 0.04) and were significantly more compliant (p = 0.02). In addition, the number of years of experience (< 5y,5-10y,10-15y, > 15y) and the current job level (resident, specialist, consultant, professor) was significantly associated with higher compliance with lead aprons (p = 0.006, p < 0.001, respectively). On regression analysis, previous radiation safety awareness courses were the only predictor of good compliance with radiation safety measures (OR = 2 ± 0.73, p = 0.009). Conclusion There was a lack of awareness and implementation of radiation safety measures among all participants. Receiving radiation safety courses was the only predictor of good compliance with radiation safety measures.