Abstract: An anatomic X-ray phantom having two layers of radiolucent material, at least one layer of metallic material therebetween, and a test pattern. The metallic layer is of a shape regionally similar to a corresponding human anatomy portion and has X-ray absorptive characteristics similar to the corresponding human anatomy portion. The test pattern is for X-ray quality assurance testing of the imaging system and is positioned inside the phantom in an area having radiopacity/radiolucency characteristics similar to the corresponding human anatomy portion. Other metallic layers also may be disposed between the two radiolucent layers. Preferably, the test pattern is directly adhered to a metallic layer on the side thereof facing the direction of the source of x-ray photons from the X-ray system.