The aim of our study was to determine the influence of ambient lighting conditions on the diagnostic performance when using digital reporting work-stations. We acquired 15 normal and 30 fractured porcine femurs using a storage phosphor system. All images were demonstrated on a high-quality image display under optimised (128 lx) and non-optimised (450 lx) ambient lighting conditions and on a conventional viewing-box under non-optimised conditions (450 lx). Results were analysed using ROC-statistics. The area under the ROC-curve was 0.895 for optimised conditions and 0.684 for non-optimised conditions using digital displays and 0.849 for the conventional viewing-box. The difference in diagnostic performance between optimised and non-optimised conditions using a digital display was highly significant (p < 0.001). Our results emphasise the importance of adequate surrounding lighting conditions for radiologic diagnostic performance, particularly for the use of digital reporting consoles.