A cross-sectional study was performed to estimate the utilization of screening mammography in a nursing home population. Included in the study were 139 women over 50 years of age who had been residing in a skilled nursing home in Connecticut for at least 1 year. Charts were reviewed to estimate screening mammography and chest x-ray examination use. Functional status of each subject was assessed by supervisory nurses using set criteria. One of the 139 subjects had received a mammogram, whereas 129 subjects (93%) had received chest x-ray examinations. Average length of stay in the nursing home was 6.5 years. No association was noted between functional status and use of mammography. It was concluded that in this clinical setting mammography appears to be underutilized as a screening test for breast cancer. The comparative data on chest x-ray examination use suggest strategies that may be useful in increasing compliance with current screening recommendations for mammography in the institutional setting.