Evidence-based imaging is a paradigm for using the best evidence to guide medical decision making. Evidence-based imaging centers on formulating a clinical question focused on a specific patient scenario, conducting a literature search and critical review, summarizing the evidence, and using the information to guide medical decision making. Additional tools important to evidence-based imaging are clinical prediction rules, designed to provide evidence for when imaging should be used, and cost-effectiveness analysis, designed to quantify the economic and patient outcomes from medical interventions.