Purpose: To create an inexpensive interface that allows image acquisition for endoscopy to be integrated into an existing PACS through the DICOM 3.0 standard. Methods and Materials: A commercial frame grabber was used to digitize the standard video signal produced by a video endoscope. As the frame grabber was equipped with hardware Motion JPEG compression, it allowed the capture of stills or live video from the endoscope at a rate of up to 30 frames per second at a resolution of 640x480 in full colour. A Windows 95/NT application was developed to provide the system with Storage Class User and Query/Retrieve Class Provider functionality for integration with an existing DICOM-based PACS. Results and Conclusions: During an examination in the endoscopy suite, image capture is triggered by a foot pedal. As images are acquired, they are converted into DICOM format. An interactive touch screen monitor serves to both view captured images and enter demographic and descriptive data. An HL7 interface allows automatic entry of patient registration data. At the conclusion of the examination, the images are transferred to a server for storage. The server automatically routes these images to existing hospital workstations. External access is possible through a secure internet link. This allows clinicians and medical imaging consultants to review the endoscopic findings along with other modalities such as ultrasound, CT, MRI, and digital contrast studies. The images may be downloaded in JPEG format for presentation, publication, and electronic transfer outside the hospital network. Further development includes use of the capture stations in laparoscopic surgery and pathology. Digital video capture and voice recognition technology will be expanded and developed as memory and hardware costs become less restrictive. Ultimately, this system will from the basis of a paperless endoscopic and multi-modality patient record.