Introduction <p>Clinical placements are critical in bridging theoretical knowledge and practical skill gaps in medical imaging education. This study evaluated the perceptions of the clinical placement learning environment among third- and fourth-year medical imaging students in Ghana.</p> Methods <p>A quantitative cross-sectional survey was conducted through a self-administered questionnaire created using Google Forms. A convenience sampling strategy was employed, and the link to the Google Form was distributed via the WhatsApp platform of Medical Imaging students. The survey evaluated supervision and support, learning integration, and clinical environment equity among the participants. Descriptive and Spearman’s rank correlation (<i>P</i> &lt; .001) were used to analyse the data.</p> Results <p>A total of 253 radiography students participated, with the majority being male (65.2%) and aged 18–24 years (85.8%). Significant associations were noted in supervision and support (<i>p</i> &lt; .001), learning integration (<i>p</i> &lt; .001), and learning environment equity (<i>p</i> &lt; .001). However, perceived challenges such as overcrowding (25.9%), increased workload (25.5%), and equipment breakdowns (18.9%) were significant concerns. Significant associations were observed among the measured variables (that is, supervision and support, learning and integration and learning environment equity) (<i>p</i> &lt; .01).</p> Conclusion <p>While students generally reported positive experiences, challenges such as overcrowding, limited supervision, and resource constraints hinder optimal learning. Addressing these issues through a timely and effective maintenance culture, improved infrastructure, and enhanced coordination between academic and clinical settings is crucial for fostering a supportive and equitable clinical placement environment.</p>