Most medical images today are generated digitally before exposure on film. In hospitals that employ Picture Archiving and Communication Systems (PACS), the images are also stored and managed digitally. Indeed, film copies of images are still used at large, but the new generation of filmless hospitals tend to minimize the production of films unless deem necessary, or required by the patients or third parties. There are basically two main reasons for working with films in 'filmless' hospitals. One is that in fact, these are 'less film' hospitals due to the film-oriented environment where they operate. Environment which has not yet entered the PACS and DICOM era; Neither in operation, nor in intercommunication. The other reason is that films are needed for legal purposes as a sole indicator to the medical image evidence used during diagnosis. PACS offer numerous advantages, but a high entry cost which can be balanced with the savings in films production and handling. However, as long as films are mandatory, they do not help to lower the inhibitory cost of PACS, and the use of films prevails.