How to View X-Rays on a CD: PC, Mac & No Drive

Medical X-ray CDs store images in a format called DICOM, and viewing them usually requires either the bundled software on the disc or a free DICOM viewer you download separately. On a Windows PC, the disc often auto-launches its own viewer. On a Mac, that bundled software almost never works, so you need a Mac-compatible viewer. And if your computer lacks a disc drive entirely, you can copy the files to a USB stick or use a cheap external drive. The process is simpler than it looks once you understand what is actually on the disc.

What Is Actually on the CD

When a hospital or imaging center hands you a CD of your X-rays, CT scans, or MRIs, the disc typically contains two things: your image files in the DICOM format and a small software program designed to display them. DICOM stands for Digital Imaging and Communications in Medicine, and it is the universal standard for medical images. Unlike a regular JPEG or PNG, a DICOM file bundles the image together with metadata like your name, date of birth, the date of the scan, and technical details about how the image was captured. A prototype display program that reads the disc’s directory structure, allows user interaction, and decompresses these image files was part of the DICOM standard’s early design.¹

The bundled viewer on the disc is almost always built for Windows. Hospitals include it so that patients and referring doctors can pop the CD in, have a program launch automatically, and start scrolling through images without installing anything extra. The disc also contains data about where the images came from, and these CDs function identically from the viewer’s perspective regardless of the imaging facility that produced them.² That sounds convenient, and on Windows it often is. The trouble starts when you are on a Mac, when the bundled viewer is outdated, or when your laptop does not have a disc drive at all.

Viewing on a Windows PC

On most Windows machines, inserting the CD triggers an autorun prompt. You may see a window asking whether you want to run the viewer application on the disc. Click to allow it, and the bundled viewer should open, showing a list of your imaging studies. From there you can select a study, scroll through individual images, zoom in, and sometimes adjust brightness and contrast. If autorun is disabled or Windows blocks the program for security reasons, open File Explorer, navigate to the CD drive, and look for an executable file (usually ending in .exe) with a name like “viewer” or “run.” Double-click it to launch manually.

If the bundled viewer does not work, fails to launch, or looks so dated that you cannot adjust the images, you can open the DICOM files directly using free third-party software. Researchers have surveyed the web for free DICOM viewing programs compatible with Windows and identified several that are user-friendly enough for non-specialists.³ Among these, programs like RadiAnt DICOM Viewer and MicroDicom are popular choices that install in minutes. You simply download the program, install it, then use it to open the DICOM files on the CD. DicomWorks is another freeware option that has been reviewed in the radiology literature for reading and working with medical images.⁴

To open the raw files, navigate to the CD in File Explorer. You will typically see a folder called “DICOM” or “IMAGES” alongside the viewer application. Inside that folder are the actual image files. They sometimes have no file extension or have an extension like “.dcm.” In a DICOM viewer, you usually open the folder (not individual files), and the software reads the directory to organize the images into studies and series automatically.

Viewing on a Mac

This is where most people hit a wall. The bundled viewer on the CD is almost always a Windows .exe file, which macOS cannot run. When you insert the CD into a Mac, you will see the disc mount on your desktop or in Finder, but double-clicking the viewer application does nothing useful. Do not try to force it; you need a Mac-native DICOM viewer instead.

The most well-known free option for Mac is Horos, which evolved from the open-source OsiriX project. OsiriX was originally developed as an open-source tool on macOS for navigating large sets of multidimensional medical images, including combined imaging studies.⁵ Horos carries that legacy forward and remains free. Download Horos from its website, install it, then drag the DICOM folder from the CD into the Horos window (or use File > Import to point it at the disc). Horos will import the images and let you scroll through them, adjust windowing, zoom, and even do basic 3D reconstructions if you have a CT or MRI scan.

For users who want something lighter, a newer project called OpenDicomViewer has been built entirely in Swift for modern macOS. It supports multiple DICOM formats, multi-panel layouts, and hardware-accelerated rendering while remaining lightweight.⁶ OsiriX itself still exists in a “Lite” version that is free but more limited than the paid edition. A veterinary software survey identified Horos, OsiriX Lite, and RadiAnt among eight free DICOM viewers that met functionality criteria including standalone use.⁷ RadiAnt is Windows-only, but the survey is useful because it confirms which viewers are genuinely free and functional for standalone use. For Mac users, Horos is the go-to.

If Your Computer Has No Disc Drive

Many laptops and some desktops sold in the last decade have dropped the optical drive entirely. You have a few options, and none of them are complicated.

External USB drive: A portable USB CD/DVD drive costs around $15 to $25 and plugs in with a single cable. It works on both Windows and Mac without any special software. Insert the CD, and your computer treats it like a built-in drive. This is the most straightforward solution if you expect to receive imaging CDs more than once.
Borrow a drive and copy the files: Find any computer with a disc drive, insert the CD, and copy the entire contents of the disc onto a USB flash drive. Portable solid-state drives and flash drives can easily store and transfer medical images from a CD.⁸ Copy the whole disc, not just the image files, so the directory structure stays intact. Then plug the USB drive into your own computer and open the DICOM folder with a viewer.
Create a disc image: On the borrowed computer, you can also create an ISO image of the CD (a single file that is an exact copy of the disc). On Windows, free tools like ImgBurn do this. On a Mac, Disk Utility can create a disc image natively. Transfer the ISO to your own machine, mount it as a virtual drive, and access the files as if the CD were physically inserted.

Whichever method you choose, the DICOM files themselves are just data files. Once they are on your hard drive or a USB stick, any DICOM viewer can open them exactly the same way it would open them from a CD. There is no copy protection on medical imaging discs.

Web-Based Viewers That Run in Your Browser

If you would rather not install any software at all, browser-based DICOM viewers let you open your files directly in Chrome, Firefox, Safari, or Edge. These viewers run entirely in your web browser using JavaScript, so they work on any operating system without installation.

One open-source option, BlueLight, implements both two-dimensional and three-dimensional medical image visualization using client-side rendering, meaning the processing happens on your own computer through the browser rather than on a remote server.⁹ Other browser-based viewers exist as well, though a survey of web-based DICOM viewers found that only four allow 3D viewing of local DICOM files beyond basic multiplanar reconstruction.¹⁰ For simply looking at X-ray images, though, you do not need 3D rendering. Flat 2D viewing with zoom and brightness adjustment is all most people are after, and most browser-based viewers handle that well.

To use one, you typically visit the viewer’s website, click a button to load local files, and select the DICOM files from wherever you saved them. The images never leave your computer since the rendering is client-side. This is a good option if you are on a work computer where you cannot install software, or if you are using a Chromebook.

Patient Portals and Cloud Access

CDs are increasingly becoming a relic. Many hospitals and health systems now offer image access through their electronic patient portals, the same login you use to check lab results and message your doctor. A multi-institutional study found that web-based image viewing through electronic patient portals has been enabled at several institutions within the past few years, typically alongside open access to radiology reports.¹¹

If your imaging provider offers portal-based image access, you can view your X-rays from any device with a web browser, no CD needed. The images load through a built-in web viewer, and you can usually adjust brightness, zoom, and sometimes even share the images electronically with another provider. Ask the imaging facility whether portal access is available before you leave with a CD. Some facilities offer both, and the portal version is generally easier to use, especially if you need to share images with a specialist in another city.

Cloud-based image sharing services like Ambra Health and Purview are also used by some imaging centers to send you a link rather than a physical disc. You receive an email or text with a secure link, click it, and view your images in a browser. These services are increasingly common for referrals between facilities, which means your doctor may already have access to your images through a digital exchange network even if you never hand them a CD.

Viewing on a Phone or Tablet

DICOM viewer apps exist for both iOS and Android. On iOS, apps like OsiriX HD (a mobile version of OsiriX) and Horos Mobile allow you to import DICOM files and view them on an iPhone or iPad. Research has demonstrated that mobile devices can handle DICOM viewing and even 3D reslicing, with one iOS app shown to perform reslicing faster than a standard image viewer by a large margin.¹² On Android, apps like RadiAnt and MedDream offer similar functionality.

The practical challenge is getting the files from a CD to your phone. You would first need to copy the DICOM files to a cloud storage service (Google Drive, iCloud, Dropbox) or transfer them via a USB adapter. Once the files are accessible from your phone, the DICOM app can open them. Viewing X-rays on a phone screen is perfectly fine for your own reference, but the small screen makes it less useful for detailed analysis compared to a laptop or desktop monitor.

Why DICOM Files Do Not Open Like Regular Photos

A common frustration is trying to double-click a DICOM file and having nothing happen, or seeing it open in a text editor as gibberish. Your computer’s built-in photo viewer does not recognize DICOM files because they are not standard image formats. They carry embedded metadata, can store multiple frames (like slices of a CT scan in a single file), and use specialized compression. Regular image viewers simply do not know what to do with them.

You can convert DICOM files to JPEG or PNG using most DICOM viewers (look for an “Export” or “Save As” option), but doing so strips out the metadata and may reduce image quality. A study comparing image file formats found that DICOM files had significantly lower image noise, higher brightness, and greater image uniformity than other common formats.¹³ Converting to JPEG is fine if you just want to text a picture of your X-ray to a family member, but if you are sending images to another doctor for a clinical opinion, always send the original DICOM files. The doctor’s software can do much more with the native format, including precise measurements, windowing adjustments, and cross-referencing the embedded scan parameters.

Privacy and Personal Health Information on the Disc

Your X-ray CD contains more than just pictures. The DICOM metadata embedded in each file typically includes your full name, date of birth, medical record number, the referring physician’s name, and sometimes your address. This is worth keeping in mind if you plan to share the disc or upload files anywhere.

If you need to share your images for a second opinion through an online service or with a researcher, be aware that the personal health information is embedded in the files themselves, not just in a separate text document on the disc. Free de-identification tools exist to strip this information from DICOM headers, but a comparison of non-commercial de-identification tools found that only five could properly remove personal health information, and four of those required careful customization beyond their default settings.¹⁴ In practical terms, if you are simply bringing the CD to another doctor’s office, privacy is not a concern since they need your information anyway. But if you are uploading images to a forum, sending them to a non-medical contact, or posting them online, the raw DICOM files will contain your personal details unless you actively strip them out or export to a standard image format first.

When the CD Just Will Not Work

Sometimes the CD itself is the problem. Discs get scratched, the data layer degrades over time, and cheap CD-R media is not built for archival storage. If your computer recognizes the disc but cannot read the files, try cleaning the disc surface with a soft cloth, wiping from the center outward. If the disc is not recognized at all, try it in a different drive or a different computer. Optical drives vary in their tolerance for scratched or degraded media.

If the disc is truly unreadable, contact the imaging facility. Most facilities keep your images on their internal picture archiving system for years (retention periods vary by state and facility, but seven to ten years is common for adult imaging). They can burn you a new disc or, increasingly, send you a digital link. Requesting a replacement is routine and usually free or very low cost.

Another common issue: the bundled viewer launches but shows a blank screen or an error message. This often happens because the viewer is so old that it is incompatible with your version of Windows. Some bundled viewers date back to Windows XP. Right-clicking the executable and choosing “Run as administrator” or setting the compatibility mode to an older Windows version sometimes helps. If it does not, skip the bundled viewer entirely and use a standalone DICOM viewer as described above. The image files themselves are fine; only the viewer software is outdated.

Quick-Start Checklist

Windows with disc drive: Insert CD, allow autorun, use the bundled viewer. If it fails, download RadiAnt or MicroDicom and open the DICOM folder from the disc.
Mac with disc drive: Ignore the bundled viewer. Download Horos, install it, and import the DICOM folder from the disc.
No disc drive: Buy a cheap USB external drive, or copy the disc contents to a USB stick on another computer, then open with any DICOM viewer on your own machine.
No software install allowed: Copy the DICOM files to your computer, then open them in a browser-based viewer like BlueLight.
Phone or tablet: Transfer DICOM files via cloud storage, then open with a mobile DICOM viewer app.
Portal available: Skip the CD entirely. Log into your patient portal and view your images through the built-in web viewer.

Keep the original CD in a safe place even after copying the files. If you ever need to prove the images are unaltered originals, the disc serves as a physical record. And if you are transferring images between doctors, handing over the CD itself is still the format most radiology departments are set up to receive, even as digital sharing catches up.