There is a worldwide concern for increased efficiency and cost effectiveness in healthcare delivery which in the USA represents about 16% of the Gross Domestic Product. The variability and complexity of the processes within healthcare systems demand the use of more sophisticated management tools, such as the recommended by a joint study by the National Academy of Engineering and the Institute of Medicine in the USA (NAE 2005), to improve the healthcare delivery system. In this chapter it is seen the integration of three management tools (Activity Based Costing, Lean Healthcare and Process Simulation) to facilitate the development of Medical Imaging Center (MIC) studies in order to improve the patient´s processes, which departs from traditional modeling because it uses a pull paradigm for the patients. Activity Based Costing (ABC Costing) is used to identify improvement opportunities from the managers' point of view, Lean Healthcare (Lean) to identify opportunities from the Customers´ point of view and Process Simulation (Simulation) to test the potential impact of any proposed alternative identified with ABC Costing or Lean, prior to its implementation. The center to be modeled might be as simple as having one x-ray machine, or, more complex having all kind of imaging machines (magnetic resonance, CT, x-ray, digestive radiology, ultrasound scan, angiography, mammography and others). Medical Imaging Centers are important units in every hospital or medical center as they are a relevant link in generating a patient's diagnostic. Because of this, it is necessary that these centers be managed with high quality standards but also with efficiency. As an application, an integrated example is provided where ABC costing, Lean and Simulation are applied to an imaging center to improve the patient's waiting times and process costs. Medical Imaging Centers have made an important investment in PACS systems, which provide data comprising from the reception of patients to the taking of the image. This kind of system gives relevant and detailed information, such as: number and kind of patient, frequency, type of exam, supplies and drugs utilized and personnel involved, all of these entry data are significantly useful to the proposed tools, and, furthermore complement and support the information for the management of MIC.