Background: Radiology technicians and interventional staff are routinely exposed to ionizing radiation, posing risks of cataracts, malignancies, and cumulative occupational hazards. Although protective measures and dose-reduction technologies exist, adherence and implementation vary in clinical settings. This systematic review aimed to evaluate radiation exposure levels and protective strategies among radiology personnel. Methods: This review followed PRISMA guidelines. PubMed, Scopus, and Web of Science were searched for randomized controlled trials and prospective comparative studies. Eligible studies assessed protective measures, dose-optimization protocols, or imaging technologies intended to reduce radiation exposure. Outcomes included effective dose, dose-area product, fluoroscopy time, and staff exposure metrics. Ten studies met inclusion criteria. Results: in different procedures, including ERCP, cardiac catheterization, atrial fibrillation ablation, orthopedic fixation, spinal surgery, hemodialysis access, and PET-CT, protective drapes, navigation systems, advanced X-ray technologies, and optimized protocols consistently reduced staff radiation exposure, often by 65–99%. Patient exposure varied, with some technologies increasing patient dose while reducing staff exposure. Importantly, dose-reduction strategies did not compromise procedural success or diagnostic accuracy. Variability in adoption in healthcare systems highlights ongoing gaps in protection practices and knowledge. Conclusion: Radiology technicians remain at significant occupational risk from ionizing radiation. Evidence supports the efficacy of protective devices, optimized imaging protocols, and advanced technologies in reducing exposure. Consistent implementation, combined with education and adherence to ALARA principles, is critical to safeguard both patients and staff.