The progressive spread of Picture Archiving and Communication System (PACS) in medical imaging constitutes some of the major changes in the radiology and hospital environment during the past decade. The major benefit of PACS resides in its ability to communicate images and reports to referring physicians in a timely and reliable fashion. Filmless radiology offers the opportunity to redesign departmental and enterprise-wide workflow with increase in efficiencies of technologists, clerical staff and radiologists. PACS may improve patient care by providing real-time radiology and by enabling teleradiology. These technologies and the changing environment in radiology may force the radiologists to become more directly involved in the triage and management decisions for the patient. Occasional consultations, regularly scheduled consultation services, and multidisciplinary clinical discussions including a radiologist may help directing physicians to the best sequence of examinations to resolve a clinical problem.