This paper on digital mammography image storage, retrieval, and transmission is 1 of 3 papers written as part of an intersociety effort to establish image quality standards for digital mammography. The information included in this paper is intended to support the development of an American College of Radiology (ACR) guideline on image quality for digital mammography. The topics of the other 2 papers are digital mammography image acquisition and digital mammography image display. The societies that were represented in compiling this document were the Radiological Society of North America, the ACR, the American Association of Physicists in Medicine, and the Society for Computer Applications in Radiology. These papers describe in detail what is known to improve image quality for digital mammography and make recommendations about how digital mammography should be performed to optimize the visualization of breast cancers using this imaging tool. Through the publication of these papers, the ACR is seeking input from industry, radiologists, and other interested parties on their contents so that the final ACR guideline for digital mammography will represent the consensus of the broader community interested in these topics.