Background: Digitisation in medical imaging – the process of converting analogue images to digital formats – has transformed healthcare by enabling improved data management, storage and sharing. However, data regarding its implementation in Chad are lacking. Objective: To assess the current state of medical imaging digitisation in major public and private hospitals in N'Djamena, Chad. Methods: A cross-sectional descriptive study was conducted from April to July 2024 across the medical imaging departments of 16 hospitals (7 public, 9 private). Data were collected using a standardised questionnaire administered to department heads, technologists and coordinators. Consecutive, non-probabilistic sampling was employed. Variables included personnel, equipment type and age, digital image sharing, archiving, file formats, maintenance, challenges and benefits. Statistical analysis was performed using Sphinx software. Results: Radiologists constituted 6.3% of respondents. The majority of hospitals used digital equipment (direct digital: 46.8%; indirect digital: 48.8%). Key obstacles to digitisation were the high cost of equipment (41.9%) and equipment obsolescence (29%). Perceived benefits included immediate image viewing/film savings (34.2%) and data transmission (29.8%). However, 93.8% of facilities lacked a Hospital Information System (HIS) or PACS. The main causes of equipment failure were electrical power fluctuations (46.2%) and incorrect use by staff (42.3%). Conclusion: Whilst digital equipment is prevalent, its full potential in N'Djamena is hampered by a critical shortage of radiologists, the absence of integrated IT infrastructure (PACS/HIS), maintenance issues and an ageing equipment fleet. Strategic investment in specialist training, resilient technical and IT infrastructure, and preventive maintenance programmes are essential to harness digitisation for improved diagnostic care.