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OBJECTIVE. The purpose of this study was to investigate how frequently second-opinion radiology reports are not read by clinicians and to identify reasons why reports are not read. MATERIALS AND METHODS. This retrospective study included 4696 consecutive second-opinion reports of external imaging examinations that were authorized by subspecialty radiologists at a tertiary care institution over a 1-year period. RESULTS. Of 4696 second-opinion reports, 537 were not read by a clinician, corresponding to a frequency of 11.4% (95% CI, 10.6-12.