Medical imaging is undergoing constant change, which has accelerated with the advent of digital imaging technology. Commonly cited benefits of digital systems include: reduced repeat examinations, image manipulation, and image transmission to multiple locations. However, there are concerns that Medical Imaging Technologists’ (MITs) knowledge of this technology is questionable and that MITs are becoming deskilled, due to over reliance on the equipment. Despite this, there seems to be limited research on the impact the introduction of digital technology has had on MITs. This study used a sequential exploratory mixed methods research design to consider how the introduction and ongoing use of digital imaging technology has affected MITs in Aotearoa NZ. Phase One drew on Interpretive Description and used semi-structured interviews to explore MITs’ personal experiences of the introduction and ongoing use of digital technology, and its perceived impact on practice. The interview findings were used in the development of a survey for Phase Two. Phase Two used a cross-sectional survey to describe and identify factors influencing MITs’ knowledge and understanding of digital imaging and its application, as well as their perceived competence in using digital technology. The overarching finding was that the introduction of digital imaging had created a major shift in MIT clinical practice, principally due to the significance of the transition being underestimated, which influenced the educative processes adopted. In turn, this led to a theory-practice gap. Despite the cited benefits of digital imaging technology, some of the underlying complexities and tensions that exist within medical imaging practice, were exacerbated through its introduction. For example: decision making around repeat imaging and whether an increased patient dose outweighs any potential risk to the patient; the limited time MITs have to build rapport with patients; and high occupational stress in MITs. Ultimately these appeared to contribute to a potentially negative impact on quality care provision.