Background: Structured reporting is increasingly recognized as a transformative tool in radiology, offering clarity, uniformity, and enhanced clinical communication. Yet, evidence from controlled methodological studies remains limited, and the pathway from conceptual design to clinical practice is not fully mapped. Methods: In this methodological proof-of-concept study, 40 synthetic emergency radiology cases were created to compare structured and free-text reporting across four domains: neurological, thoracic, abdominal/pelvic, and vascular/other acute pathologies. Reports were assessed for diagnostic accuracy, completeness, clarity of expression, and clinical relevance using descriptive analysis. Results: Structured reports outperformed free-text formats in completeness, clarity, and clinical relevance, reducing ambiguity and ensuring systematic inclusion of key diagnostic elements. Diagnostic accuracy was comparable overall, with structured formats offering greater consistency and protection against omission. These findings, while derived from synthetic cases, highlight the tangible advantages of structured reporting in enhancing radiological communication and decision support. Conclusions: Structured reporting represents a pivotal advancement in radiology, capable of delivering standardized, accurate, and clinically actionable outputs. This proof-of-concept study provides foundational evidence for its feasibility and value. Importantly, it sets the stage for the next phase, namely clinical validation and real-world integration, where structured reporting—augmented by artificial intelligence—may redefine diagnostic efficiency and interdisciplinary collaboration.