We make heavy use of the Drupal image assist module (or img_assist as its known) - but find that its handling of empty alt tags is quite poor. The problem being that if when inserting the image the user does not specify a caption or description then the alt (and title) attributes are both empty.
This is clearly not ideal on a modern standards compliant site - luckily the solution to the image assist alt tag problem is a little theme override.
function phptemplate_image_display($node, $label, $url, $attributes) {
if (!$node->title){
$node_temp = node_load($node->nid);
$node->title=$node_temp->title;
}
return theme('image', $url, $node->title, $node->title...