It is well known that x-rays used for surgical planning vary in magnification. This variation exists in part because of the diversity of techniques used by x-ray technologists, patient positioning, and the patient’s size. Even with strict imaging protocols, the magnification of an x-ray image can vary. A thin patient lying on an imaging receptor is only a few inches above the plate, giving little distance for the X-rays to diverge. In a larger patient, the distance may be twice as far from the plate, allowing the divergent beam to spread much more before it hits the plate. This can result in a magnification factor of approximately 20%. Scaling an x-ray image is mandatory to assure the highest level of accuracy throughout the planning process, especially orthopedic templating. Does size matter when it comes to magnification of an x-ray and surgical planning? Absolutely! Preoperative planning aims to reduce the risk of intraoperative fracture and decrease overall surgical time. Images that are used for surgical planning must be accurately scaled to allow for accurate implant selection.