The application of PACS in the teaching is an hot focus in current medical imaging teaching reformation , and the establishing of independent medical imaging teaching case database based on PACS-HIS is the first and key of construction of teaching PACS(T-PACS). Several key steps of designing and constructing database will be discussed in this paper. ①To customize case classifi-cation and code according to the medical imageology textbook. ②To construct the independent case database meeting the teaching needs. ③To establish a set of mechanism of collection teaching cases based on real time in clinical PACS environment. ④development of experiment teaching application etc.