The U.S. radiologist workforce has experienced periods of growth as well as stagnation and downturns, with concerns of radiologist oversupply during tight job markets followed by perceived workforce shortages. Major issues facing the radiologist workforce today include: impacts of accumulated policy changes; mismatch between the demand for radiologist services and the current size of the radiologist workforce; dissatisfaction, turnover, and burnout among radiologists; challenges in radiology resident education due to employment trends; and the promise and challenges of artificial intelligence. To address current and future workforce shortages, radiology as a profession must adapt to ongoing stresses and the changing care ecosystem by promoting appropriate utilization, leveraging all existing workforce reserves, and embracing innovation. In this AJR Expert Panel Narrative Review, we explore the recent history of the U.S. radiologist workforce; examine the political, social, and educational milieus faced by current and future radiologists; and consider the effects of disruptive technology.