Purpose: We have conducted a questionnaire survey every 5 years since 1974 to understand the existing status of X-ray equipment. This time, we report on the results of the fiscal 2020 diagnostic X-ray equipment questionnaire survey. Methods: We responded using Excel and collected the information online. Results: Compared to the previous survey on X-ray equipment, there has been a progress in the introduction of inverter-type X-ray generators and image receptor systems in digital systems. We think that this transition will occur when the X-ray equipment is updated. In addition, equipment management was performed at many facilities. It seems that the importance of quality control for X-ray equipment is becoming more widespread. Consistency tests compatible with digital systems were conducted at each facility. Maintenance by manufacturers has also increased. This is considered to be because the equipment management of digital systems has become more difficult. Dose management was also actively carried out. Conclusion: We believe that it is necessary to continue the survey on the status of diagnostic X-ray equipment.