Integration of RIS and PACS services into a single solution has become a widespread reality in daily radiological practice, allowing substantial acceleration of workflow with greater ease of work compared with older generation film-based radiological activity. In particular, the fast and spectacular recent evolution of digital radiology (with special reference to cross-sectional imaging modalities, such as CT and MRI) has been paralleled by the development of integrated RIS--PACS systems with advanced image processing tools (either two- and/or three-dimensional) that were an exclusive task of costly dedicated workstations until a few years ago. This new scenario is likely to further improve productivity in the radiology department with reduction of the time needed for image interpretation and reporting, as well as to cut costs for the purchase of dedicated standalone image processing workstations. In this paper, a general description of typical integrated RIS--PACS architecture with image processing capabilities will be provided, and the main available image processing tools will be illustrated.