Objectives: The use of radiological examination is increasing worldwide. Since radiation exposure can result in many health hazards, medical professionals, as well as medical students, should possess adequate knowledge regarding radiation and its related hazards to protect themselves and the patients. Many studies have assessed medical students’ knowledge on this topic, but never in Kerala. In this study, we aimed to examine medical students’ awareness and knowledge regarding radiological examination modalities and their risks on themselves and their patients. To examine the level of knowledge about the radiation exposure to various radiological modalities among the medical students and to suggest how education could be improved. Material and Methods: This was an observational, cross-sectional, population-based study, conducted among all medical students and interns from Believers Church Medical College Hospital in Kerala. Participants were asked to complete a questionnaire consisting of their actual knowledge on ionizing radiation and various radiation safety issues. A total knowledge score that ranged from 0 to 20 was calculated for each participant, with higher scores indicating better knowledge regarding radiation doses and the related hazards. All questions were in multiple choice formats ranging from 4 to 5choices. The obtained data were analyzed using statistical software. Results: Four hundred and forty seven students participated in our study, with a response rate of 71%. The average knowledge score of the participants was 10.97 ± 1.31 out of a maximum of 20 points. More than half of the students were aware of radiation shielding and the contraindication to radiological modalities. Approximately 78.9% of respondents underestimated or do not know the American College of Radiology (ACR) Appropriateness Criteria. Conclusion: This study has clearly shown that awareness of ionizing radiation from diagnostic imaging is lacking among senior medical students and interns. The results highlight the need for improved education to minimize unnecessary exposure of patients.