This publication reports the results of a recent IAEA coordinated research project on patient dose optimization in fluoroscopically guided interventional procedures. The optimization of radiological protection of patients undergoing medical exposure has become an important issue, since many surgical procedures have increasingly been replaced by fluoroscopy based interventional procedures, which can cause higher radiation exposure. The summary presents detailed information on the assessment of high skin doses, analyses the factors causing radiation skin injury and makes recommendations on how to avoid or reduce the likelihood of such complications.