Ionography is a possible replacement for silver halide based imaging systems in diagnostic radiology. This type of imaging depends upon the ionisation produced in a gas by incident x-radiation. The ions formed are collected on a plastic foil and the image is made visible by a suitable development process. The physical design properties which can affect sensitivity and image quality of an ionography system are outlined in this paper. Based upon the requirements of adequate sensitivity and resolution an atmospheric pressure ionography system is described which has been designed primarily for use in mammography. Freon 13B1 gas was chosen as the x-ray absorbing medium because it contains a relatively high atomic number atom (bromine, Z = 35) and also has a high density. It is a relatively cheap gas, has a high breakdown potential and has satisfactory resolving capability, particularly when employed at atmospheric pressure with low energy x-ray beams. The performance of the system is discussed in terms of sensitivity and resolution. Problems associated with an atmospheric pressure system are outlined and possible solutions described. Preliminary clinical results obtained with the system are also presented.