During the last decade, Picture Archiving and Communication Systems (PACS) have often been discussed and occasionally implemented. Many of the early installations were research- oriented, providing essential data and feedback, but yielding very few solutions to clinical problems. In the last five years, PACS has slowly gained recognition as a tool for addressing immediate problems and challenges associated with the film-based diagnostic imaging process. As the technology has migrated from laboratory to clinical environment, personnel responsible for implementing PACS have been challenged with an unenviable and often impossible task. A structured and thorough planning process should be executed in preparation for PACS. In general, this process is applicable for all PACS projects. On the average, this process will require 12 - 18 months for completion. Once the decision to move forward with a project has been made, it is imperative that the institution makes the commitment to allocate the necessary personnel, financial, and other resources to ensure the success of the project. Following this process can not guarantee complete success in all cases. However, doing so can minimize the problems encountered during and after implementation and reduce the risk of unfulfilled expectations.