The purpose of this study is to investigate the effect of differences in grid focal distance used in general radiography on the exposure index and image quality, and to provide useful information for the application of grids in clinical radiography. With AEC applied and SID set to 110 cm, 30 images were obtained for each focus distance of the grid at 110 cm, 140 cm, and 180 cm under the same exposure conditions. The dose was measured using the DAP and ESD, while image quality was evaluated using the SNR and CNR. The exposure index (EI) was determined based on the values shown in the image. EI was derived from the values indicated in the images. The mean DAP values at focus distances of 180, 140, and 110 cm were 10.944±0.613, 10.687±0.516, and 9.74±0.588 cGy·cm2, respectively. The ESD values were 1041.75±57.92, 1019.99±49.61, and 930.86±55.77 μGy, while the EI values were 205.97±11.77, 210.59±10.37, and 193.8±11.86. The SNR values were 28.48±0.62, 28.41±0.64, and 27.13±0.72 dB, and the CNR values were 0.09859±0.004276, 0.09864±0.004378, and 0.09026±0.004783 dB. The differences in the mean values were statistically significant (p < 0.01). The values were significantly higher at focal distances of 140 cm and 180 cm compared to 110 cm, but there was no significant difference between the focal distances of 140 cm and 180 cm. The correlation analysis results revealed significant negative correlations between FD and DAP (r = -0.642, p < 0.01), ESD (r = -0.629, p < 0.01), EI (r = -0.376, p < 0.01), SNR (r = -0.615, p < 0.01), and CNR (r = -0.575, p < 0.01) for all variables. The results of this study showed a moderate negative correlation between the focus distance of the grid and the SNR, CNR, DAP, and ESD, and a weak negative correlation with the EI. Therefore, radiological technologists should be aware that even when the same exposure conditions are applied using an AEC system, variations in focus distance of the grid can affect the exposure index, dose, and image quality. Careful consideration is needed when setting the target exposure index.