Purpose <p>This study proposes a method for real-time visualization of scatter radiation using a high-sensitivity CMOS camera with a pinhole collimator, within the energy range relevant to diagnostic imaging. Additionally, Monte Carlo simulations were employed to validate whether the measured data accurately represent actual scatter radiation.</p> Methods <p>A real-time scatter radiation imaging system was developed using a CMOS camera, CsI scintillator, and pinhole collimator. Various parameters, including pinhole diameter and exposure time, were evaluated to identify the optimal configuration. Monte Carlo simulations were used to compare the measured data against the simulated scatter radiation distribution.</p> Results <p>The system successfully visualized scatter radiation sources with high spatial resolution. The optimal parameters were identified as a 2&#xa0;mm pinhole diameter and 50 ms exposure time, balancing image clarity and efficiency. The measured data closely matched the simulation results, confirming the accuracy of the system.</p> Conclusions <p>The proposed system offers significant potential for enhancing radiation protection in clinical settings by enabling real-time visualization of scatter radiation. It is expected to contribute to safer working environments and more effective radiation safety management during diagnostic procedures.</p>