The design and the performance of a 20 cm by 20 cm flat panel x-ray detector for digital radiography and fluoroscopy is described: Thin film amorphous silicon (aSi) technology has been used to build a 1024 by 1024 photodetector matrix, each pixel including both a photodiode and a switching diode; the pixel size is 196 by 196 micrometers2. A high resolution and high absorption CsI(Tl) scintillator layer covers the top of the photodetector matrix in order to provide for x ray to light conversion. For low electronic noise and 30 fr/s operating rate we developed a custom design charge readout integrated circuit. The detector delivers a 12 bit digital output. The image quality, signal to noise ratio, and DQE are presented and discussed. The flat panel detector provides a MTF in excess of 30% at 2 lp/mm and a high contrast ratio without any distortion on the whole imaging area. The x-ray absorption is 70% for 50 KeV photons. The readout amplifier is optimized to reduce the electronic noise down to 1000 e-. This low noise level, combined with high sensitivity (1150 e-/incident x-ray quantum) provides the capability for fluoroscopic applications. The digital flat panel detector has been integrated in a C-arm system for cardiology and has been used on a regular basis in a European hospital since February 1995. The results are discussed for several operating modes: radiography and fluoroscopy. Conclusions on present detector performances, as well as further improvements, are presented.© (1996) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.