Yes—both medium- and large-format film are still actively used, and film is still available, especially in black and white. While they’re niche compared with digital, there is ongoing interest from enthusiasts and some professionals.

The main reason to use these formats is image quality and process: larger negatives can offer advantages in resolution, sharpness, tonal range, and overall rendering. Large format also encourages a slower, more deliberate way of working, which many photographers value.

That said, most clients won’t specifically ask for medium or large format. Modern full-frame digital cameras have reduced the practical gap for many jobs. So whether it’s “worth it” depends on your needs: if you have a specific artistic goal or a job that benefits from the format, it can make sense. If not, buying in may be hard to justify.

A sensible approach is to try or rent one first, or spend time with someone who already shoots these formats. That will tell you whether you enjoy the workflow enough to make the investment worthwhile.