Problem statement: Medical images such as x-rays, ultrasounds and Magnetic Resonance Imaging (MRI) plays an important role in helping th e physicians to diagnose a disease or body conditions. These images can be tampered with exist ing image processing tools that is easily available . The usage of security measures such as watermarking can protect the integrity of the images. Numerous watermarking schemes with basic security functions and even tampered image recovery are available. But there is no research on the experime ntation of watermarking in the operational environment that involves Picture Archiving and Communication Systems (PACS). Approach: This study focused on the experiment of selected waterma rking scheme running in a simulated Digital Imaging and Communications in Medicine (DICOM) compliant PACS environment. A tamper detection and recovery watermarking was applied to an ultrasound image. Image will then be transferred to another computer within the PACS. Tr ansferred and non-transferred image were tampered in the exact manner. The effectiveness of the watermarking scheme is known by comparing its recovery rates between these two tampered image s. Results: The result showed that both transferred and non-transferred image had the recov ery rates of 100% and recovered areas were identical. Conclusion: The result of the experiment showed that the selec ted watermarking scheme remains effective in a PACS environment. Further development is needed for a program that embeds watermark into images before it is sent to the PACS archive server for storage. The watermarking scheme tested needs to be further improved to be re versible for better implementation in PACS.