This document discusses the interactions between x-rays and matter. There are three main interactions - photoelectric effect, Compton scattering, and coherent scattering. The photoelectric effect occurs when a photon ejects an inner shell electron from an atom. This produces characteristic x-rays and leaves the atom ionized. Compton scattering involves the deflection of photons by outer shell electrons, producing scattered radiation. At diagnostic energies, Compton scattering is the most common interaction. The photoelectric effect dominates for high atomic number materials and low energy x-rays. These two interactions are most important in diagnostic radiology, while coherent scattering, pair production and photodisintegration occur at higher energies.