We describe a new personal computer based image transfer and storage system. We prospectively assessed the uses and benefits of ImLink (Electronic Imaging Ltd.) in a regional neuroradiology department linked by the system to six referring district general hospitals. One hundred and fifty consecutive CT scans transferred by the system were analysed (142 head, four spine and four body scans). Sixty-eight CT scans were of acute neurosurgical cases. A significant change in management occurred in 55 of these cases (81%), principally as a result of prevention of transfer of head-injured patients when no neurosurgically correctable lesion was evident. The high quality of transferred images achieved by the system allows the provision of specialist radiological advice to colleagues in linked district hospitals. A further 50 non-acute head CT scans were transferred by district hospital radiologists seeking the second opinion of a neuroradiologist. Twenty-three out-of-hours acute head CT scans were transferred from clinicians in our own hospital to the home of the on-call neuroradiologist. Overall 63% of the 150 scans were transferred during normal working hours. We discuss the multiple uses and future potential for such an image transfer and storage system.