The Picture Archiving and Communication System (PACS) is a digital technology used for the electronic storage, management, retrieval, and distribution of medical images in radiology departments. In regional healthcare settings in the Philippines, the transition from conventional to digital imaging systems is often affected by technical and organizational barriers that may influence professional performance and workflow efficiency. This study aimed to determine the level of acceptance and identify the perceived challenges of PACS among 67 radiologic technologists in selected level 2 private hospitals in Laguna as a basis for a proposed action plan. The researchers employed a quantitative descriptive research design and gathered data through a validated survey questionnaire adapted from the Technology Acceptance Model (TAM) and the Information Systems Success Model (ISSM). Findings revealed a very high level of PACS acceptance (WM = 3.54), particularly in Perceived Usefulness (WM = 3.66), Behavioral Intention (WM = 3.64), Attitude Toward Use (WM = 3.54), and Perceived Ease of Use (WM = 3.33). In terms of perceived challenges (WM = 2.19), System Quality was identified as a moderate challenge (WM = 2.87), while Information Quality (WM = 2.23) and Training Quality (WM = 1.93) were considered minor challenges, and Support Quality (WM = 1.73) was identified as not a challenge. These findings suggest that radiologic technologists demonstrate high readiness and acceptance toward PACS; however, digital workflows remain affected by infrastructure instability and dependence on informal training practices. Therefore, the proposed action plan focuses on technical system improvements and standardized vendor-facilitated training programs to address these challenges and sustain the high level of PACS acceptance among radiologic technologists.