Picture Archiving and Communication System (PACS) is a system which connects imaging modalities, image archives, and image workstations to reduce film handling cost and improve hospital workflow. Handling diagnostic ultrasound and endoscopy images is challenging, because it produces large amount of data such as motion (cine) images of 30 frames per second, 640 x 480 in resolution, with 24-bit color. Also, it requires enough image quality for clinical review. We have developed PACS which is able to manage ultrasound and endoscopy cine images with above resolution and frame rate, and investigate suitable compression method and compression rate for clinical image review. Results show that clinicians require capability for frame-by-frame forward and backward review of cine images because they carefully look through motion images to find certain color patterns which may appear in one frame. In order to satisfy this quality, we have chosen motion JPEG, installed and confirmed that we could capture this specific pattern. As for acceptable image compression rate, we have performed subjective evaluation. No subjects could tell the difference between original non-compressed images and 1:10 lossy compressed JPEG images. One subject could tell the difference between original and 1:20 lossy compressed JPEG images although it is acceptable. Thus, ratios of 1:10 to 1:20 are acceptable to reduce data amount and cost while maintaining quality for clinical review.