PURPOSE: To quantify the potential effect of geographic factors on the frequency of honorary authorship in four major radiology journals. MATERIALS AND METHODS: In this institutional review board-approved study, an electronic survey was sent to first authors of all original research articles published in American Journal of Roentgenology, European Radiology, Journal of Magnetic Resonance Imaging, and Radiology during 2 years (July 2009 through June 2011). Questions addressed guidelines used for determining authorship, perception of honorary authorship, and demographic information. Univariate analysis was performed by using χ(2) tests. Multiple-variable logistic regression models were used to assess independent factors associated with the perception of honorary authorship. RESULTS: Of 1398 first authors, 328 (23.5%) responded. Of these, 91 (27.7%) perceived that at least one coauthor did not make sufficient contributions to merit authorship, and 165 (50.3%) stated that one or more coauthors performed only "nonauthor" tasks according to International Committee of Medical Journal Editors (ICMJE) criteria. The perception of honorary authorship was significantly higher (P ≤ .0001) among respondents from Asia and Europe than from North America and in institutions where a section or department head was automatically listed as coauthor. A significantly lower (P ≤ .0001) perception of honorary authorship was associated with adherence to ICMJE criteria and with policies providing lectures or courses on publication ethics. CONCLUSION: Perceived honorary authorship was substantially higher among respondents from Asia and Europe than from North America. Perceived honorary authorship was lower with adherence to the ICMJE guidelines and policies providing lectures or courses on publication ethics.