The purpose of this study was to evaluate clinical attitudes and expectations in the implementation of a neuroradiology picture archiving and communication system (PACS). A 1-page survey of expectations and clinical attitudes toward a neuroradiology mini-PACS was dist¡ to 49 full-time faculty members in the departments of neurosurgery, neurology, and otorhinolaryngology at an academic center. Interest in viewing soft-copy images was moderate to very high for over 89% of clinicians. AII clinicians were comfortable with phone consultations with radiologists while viewing soft-copy images. Clinicians preferred retrieving images from personal computers over workstations and film libraries by 72.9%, 27.1%, and 0%, respectively. However, 38.5% of surgeons felt the need for hard copy in the operating room. Clinicians estimated that in 18.3% of cases, patients took their in-house films to outside institutions for consultations. Clinicians were enthusiastic about implementing PACS. Although acceptance of soft-copy viewing among clinicians is high, some provision for supplying hardcopy images appears to be necessary.