The importance of quality assurance (QA) of X-ray equipment in diagnostic imaging departments is well recognised. However, practically no attention has been paid in the literature to the application of QA programmes to mobile C-arm fluoroscopy systems. This equipment is sometimes omitted from these programmes because it is often “off-site” from the main radiological facility and suitable QA protocols are unavailable. The need for QA can be substantiated by the fact that these systems are finding greater clinical use in orthopaedic, vascular and cardiac applications. Hence, there is a growing awareness among users for the need of good image quality and low patient radiation dose. In view of this, the objective of this study was to review the existing literature, design a suitable QA protocol for this equipment and use it to survey 10 C-arms in clinical use. The protocol was designed to address mechanical and electrical safety in addition to radiation safety and image quality. Results indicate substantial performance differences between systems with significant variations in input air kerma rate to the image receptor. The authors believe that such a protocol is necessary with a view to establishing optimal performance levels and assist in the development of suitable “write-off” criteria for such systems.