Best Horos Alternatives in 2026
The top Horos alternatives are Intelerad IntelePACS, Sectra PACS and Fujifilm Synapse PACS: 15 radiology software our editors would look at instead of Horos, in our ranking order.
Horos: A focused desktop viewer for local DICOM review, visualization, and network transfer. Where it falls short: no RIS functionality.
Switching from Horos? For most radiology software buyers the best Horos alternative is Intelerad IntelePACS, built for hospitals needing enterprise PACS breadth. Orthanc has a free plan.
Why People Look for a Horos Alternative
- No RIS functionality
- Limited to desktop viewing rather than a hosted cloud service
- Mac-only availability excludes users on other platforms
- No rIS included — 3 of the alternatives below have it
Quick Picks by What You Need
- Best overallIntelerad IntelePACS9.2
Hospitals needing enterprise PACS breadth
Visit Intelerad IntelePACS - Best free optionOrthanc8.2
Has a free plan
Visit Orthanc - Best for ris includedEpic Radiant8.7
RIS included (Horos: no)
Visit Epic Radiant
All 15 Horos Alternatives, Ranked
Advertiser disclosure: iTechGuides is reader-supported. Vendors can pay for top positions in our rankings and for a place on other products' pages, and we may earn a commission when you click some links. Bought places stand at the number bought; this page and our disclosure say so. Paying vendors may get a fuller, more detailed review from our editors, and that review can change their score. How we rank.
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Best forHospitals needing enterprise PACS breadth
- Better than Horos:
- Editor score 9.2 vs 8.0
An enterprise PACS spanning diagnostic viewing, specialty workflows and clinical integrations.
9.2/10★★★★★Visit Intelerad -
Best forOrganizations needing PACS with clinical access
- Better than Horos:
- Editor score 9.1 vs 8.0
A hybrid PACS combining diagnostic viewing, workflow tools, and clinical image access.
9.1/10★★★★★Visit Sectra -
Best forMulti-specialty imaging and remote reading
- Better than Horos:
- Editor score 9.0 vs 8.0
A broad enterprise PACS for multi-specialty imaging, remote reading, and AI worklists.
9.0/10★★★★☆Visit Fujifilm -
Best forAdvanced diagnostic imaging across locations
- Better than Horos:
- Editor score 8.9 vs 8.0
A diagnostic imaging platform for distributed teams needing advanced viewing tools.
8.9/10★★★★☆Contact Visage -
Best forHospitals and imaging networks needing enterprise PACS
- Better than Horos:
- Editor score 8.8 vs 8.0
Enterprise PACS for networks that need image access, diagnostic viewing, and reading workflows.
- PACS included
- Diagnostic DICOM viewer
8.8/10★★★★☆Visit site -
Best forHealthcare organizations needing radiology workflows
- Better than Horos:
- RIS included
- Editor score 8.7 vs 8.0
A radiology information system for coordinating exams, reporting, follow-up, and performance.
- RIS included
8.7/10★★★★☆Contact Epic -
Best forCloud radiology teams wanting PACS and AI workflows
- Better than Horos:
- Editor score 8.6 vs 8.0
A cloud PACS that unifies DICOM management, diagnostic viewing, worklists and AI workflows.
8.6/10★★★★☆Visit RamSoft -
Best forMid-size and enterprise radiology departments
- Better than Horos:
- RIS included
- Editor score 8.5 vs 8.0
A broad RIS workflow suite for departments that need reporting, documentation, and system connections.
- RIS included
- Modality worklist
8.5/10★★★★☆Contact medavis -
Best forTeams prioritizing radiology scheduling and reporting
- Better than Horos:
- RIS included
- Editor score 8.4 vs 8.0
A cloud RIS focused on imaging workflows, scheduling, worklists and reports.
- Structured reporting
- RIS included
- Modality worklist
8.4/10★★★★☆Contact RamSoft -
Best forEnterprises needing image distribution and viewing
- Better than Horos:
- Editor score 8.3 vs 8.0
Enterprise imaging for archiving, distributing and viewing DICOM studies across clinical sites.
- PACS included
- Diagnostic DICOM viewer
8.3/10★★★★☆Visit Mach7 -
Best forTeams building a self-hosted DICOM archive
- Better than Horos:
- Editor score 8.2 vs 8.0
A self-hosted DICOM foundation for teams assembling their own radiology archive.
8.2/10★★★★☆Visit Orthanc -
Best forTeams needing a free, self-hosted DICOM archive
- Better than Horos:
- Editor score 8.1 vs 8.0
A no-license-cost, self-hosted DICOM archive for teams with separate viewer and RIS tools.
- PACS included
- Modality worklist
8.1/10★★★★☆Visit dcm4che -
Best forSmall teams needing cloud viewing and mobile access
A cloud PACS with browser diagnostics, mobile access, and secure DICOM sharing.
7.9/10★★★★☆Visit PostDICOM -
Best forWindows users needing advanced DICOM viewing tools
A Windows desktop viewer with advanced image tools, but not a PACS or RIS.
- Diagnostic DICOM viewer
7.8/10★★★★☆Visit RadiAnt -
Best forTeams needing simple cloud image sharing
A cloud PACS for teams that need browser-based access to organize and share DICOM studies.
7.7/10★★★★☆Visit Medicai
Horos Alternatives: Common Questions
What is the best alternative to Horos?
Intelerad IntelePACS: #1 in our Radiology Software ranking, with an editor score of 9.2 out of 10. An enterprise PACS spanning diagnostic viewing, specialty workflows and clinical integrations.
Is there a free alternative to Horos?
Yes. Orthanc and dcm4chee Archive have a free plan or a free tier.
Why do people look for Horos alternatives?
No RIS functionality; Limited to desktop viewing rather than a hosted cloud service; Mac-only availability excludes users on other platforms.
How do I switch from Horos?
Export your data from Horos (most tools have an export in their settings). Sign up for the alternative; start on its free plan or trial if it has one. Import your export and set up the integrations your team relies on. Run both side by side for a short while, then cancel Horos.
How to Switch from Horos
- Export your data from Horos (most tools have an export in their settings).
- Sign up for the alternative; start on its free plan or trial if it has one.
- Import your export and set up the integrations your team relies on.
- Run both side by side for a short while, then cancel Horos.
Horos vs Each Alternative
| # | Tool | Free plan | Paid from | RIS included | Deployment | Score |
|---|---|---|---|---|---|---|
| 13 | Horos | Yes | Free | No | On-premises | 8.0 |
| 1 | Intelerad IntelePACS | 9.2 | ||||
| 2 | Sectra PACS | No | 9.1 | |||
| 3 | Fujifilm Synapse PACS | No | 9.0 | |||
| 4 | Visage 7 | Cloud | 8.9 | |||
| 5 | Siemens syngo.plaza | No | Both | 8.8 | ||
| 6 | Epic Radiant | Yes | 8.7 | |||
| 7 | RamSoft OmegaAI | Cloud | 8.6 | |||
| 8 | medavis RIS | No | Yes | 8.5 | ||
| 9 | RamSoft RIS | No | Yes | Cloud | 8.4 | |
| 10 | Mach7 eUnity | No | No | 8.3 | ||
| 11 | Orthanc | Yes | Free | On-premises | 8.2 | |
| 12 | dcm4chee Archive | Yes | Free | No | On-premises | 8.1 |
| 13 | PostDICOM | Cloud | 7.9 | |||
| 14 | RadiAnt DICOM Viewer | No | No | On-premises | 7.8 | |
| 15 | Medicai | Cloud | 7.7 |
Reviewed by iTechGuides Editors · Editorial team · Updated Oct 2026
Last updated · How we research and update