Background: Systematic chest X-ray is the most prescribed examination by occupational physicians during periodic medical check-ups in our context, unlike in most countries where this practice has been discontinued. Objective: The objective was to determine the diagnostic yield and cost-effectiveness of chest radiography during periodic medical check-ups of workers in Ngaoundere. Materials and methods: A cross-sectional and descriptive study carried out in Ngaoundere Regional Hospital, from January to December 2018, concerning all persons coming to perform a systematic chest X-ray in the context of the periodic medical check-up having consented to participate in the study. Postero-anterior (PA) chest radiographs were obtained from all workers during this periodic medical check-ps. The variables studied were: age, sex, clinical manifestations, antecedents, job type, cost, and chest X-ray results. Statistical analysis was performed using the Sphinx Plus² - Lexica-V5 Edition software. Results : 753 workers were selected for this study, of whom 88.04% were men and 11.96% women, a sex ratio H / F of 7.4, the average age was 39 ± 7.89 years, with extremes of 24 and 56 years, the most frequent job type were the administration (38.37%), the storekeepers (17.92) and the drivers (15.27%), most of them were asymptomatic (97,47%), some had cough (2.52%), chest pain (2.12%), dyspnea (0.26%) and fever (0,13%). History was dominated by lung infection (2.39%), pleurisy (1.06%) and tuberculosis (0.79%). 7.43% of workers occasionally smoked tobacco and consumed alcohol. 41 cases of pathologies (5.44%) were found on the chest x-ray, including 1 case (0.13%) of major pathology, 40 cases (5.31%) of minor pathologies. When the results of the chest X-ray are compared with the clinical signs and the pathological history of the workers, it is found that the only case with major abnormalities on the chest X-ray showed clinical signs and that the other cases with minor abnormalities had either clinical signs or antecedents related to these abnormalities. The cost of a chest x-ray at the time of our study was 5,000 FCFA ($8.59), for a total of 3. 675 000 FCFA ($6473.74) for all the x-rays performed. Conclusion: In view of the low rate of abnormalities on the chest x-ray and the minor nature of the pathologies, it can be said that the routine X-ray of the chest during the periodic medical check-ups has a low diagnostic yield and a low cost-effectiveness ratio and is not profitable. It should be non-systematic and case-by-case based on the clinical context and background of workers.