In this first Maltese national mammography survey, the effectiveness of direct digital (DR) mammography in breast cancer screening has been confirmed. Patient data were made available from three clinics out of the participating nine. A dose survey of mean glandular dose (MGD) calculated for 759 patients examined in the state-owned mammography facilities was performed. An MGD national diagnostic reference level was set at 1.87 mGy for patients with breast compression thicknesses (BCT) between 5.0 and 7.0 cm. This range was selected since patient data were retrieved from three clinics only and the results showed that other international BCT reference levels may be unsuitable for the Maltese population. In fact, the overall average BCT was 5.75 ± 1.4 cm. The survey results have shown that the technical standard of mammographic equipment in the Malta National Breast Screening Programme is on a par with other countries, including its Western European counterparts.