Objective: To determine the frequency of significant pathologies on lateral cephalograms discovered by orthodontists during their careers. Materials and Methods: A five-statement survey was sent to the 417 active and affiliate members of the Edward H. Angle Society of Orthodontists. The survey asked orthodontists to identify any significant radiographic pathology that they had discovered on lateral cephalograms during their careers to date. The data were analyzed statistically. Results: Of the 417 surveys, 201 were returned for a 48% response rate. Ninety-nine respondents or 49.3% of the sample had discovered at least one significant pathology. Of the 1.3 million patients observed by the orthodontists in the sample, 268 patients (0.02%) with significant pathologies had been identified. Younger orthodontists had a statistically greater potential to discover pathologies than older orthodontists. The general types of pathologies discovered were musculoskeletal (38%), glandular (28%), and dental groups (12%). Conclusions: About 50% of orthodontists will likely discover a significant, potentially life-affecting pathology on a lateral cephalogram. (Angle Orthod. 2011;81:58-63.)