Introduction Digital Radiology is on the cutting edge of medical technology and swiftly replacing traditional film-based image processing. Radiology departments in hospitals and clinics all over the world are rapidly becoming fully digitized. The Stallings Group Picture Archive Computer System (SG PACS) has been online at Department of Defense medical facilities for several years. Since inception, SG PACS has consistently exceeded 99.9% up time and availability. Built-in redundancies and fail-safe design characteristics make the system overly robust, capable of meeting the needs of today's most demanding health care provider. Features such as clustering, redundancy, and self-monitoring contribute to system reliability. The SG PACS is the largest operational system of its kind in the world today. The system core consists of Hitachi Storage, managed by the latest Windows and Unix operating systems. The user interface includes quality control stations, high-resolution multi-monitor diagnostic stations, and global web server capabilities. The SG PACS offers all the standard features of a PACS including almost limitless archiving capabilities, rapid file storage and retrieval, detailed image display, efficient study processing and recording, and one-click report generation. In additional, this system offers extensive teleradiology capabilities, old film digitization, and automated image file routing. The SG PACS' fully digital, large-scale radiology capabilities maximize efficient use of resources by increasing throughput, productivity, and reliability in radiology departments. Stallings Group 2004