Display omitted •Imaging specialists have a key role during structural heart intervention.•Imaging specialists are exposed to high doses of X-ray radiation.•Imaging specialists should therefore be protected and monitored.•Imaging specialists must be educated on radiation safety regarding ALARA principles.•Structural procedural rooms should be adapted to shield the team maximally. Structural heart interventions are steadily increasing, and the majority requires echocardiographic guidance. As a result, imaging specialists are exposed to the harmful effects of scattered ionizing radiation. This X-ray exposure must be quantified, its potential consequences should be monitored by occupational medicine and the “as low as reasonably achievable” principles of radioprotection should be optimized (including increasing the distance, decreasing the duration, using shielding radiation and providing safety training for the imaging specialist). The spatial organization of and shielding provision in the procedural rooms should be designed to optimize radioprotection for all team members.