Objective To evaluate the quality of chest DR and its influencing factors during remote imaging diagnosis in collaboration with Huayi Minsheng Imaging Center.Methods In the remote imaging diagnosis system of Huayi Minsheng Imaging Center, 20 patients were randomly selected each month between January 2017 and May 2018 at the medical imaging diagnosis base of Weichang County to score the chest posterior-anterior DR images according to the “Guidelines on Quality Criteria for Diagnostic Radiographic Images” published by the Commission of the European Community (CEC). At the same time, the information on the equipment and each patient was collected while the factors that influenced DR images were analyzed.Results After joining the medical association, the DR image quality was improved compared with the first quarter(P<0.05). Multivariate linear regression analysis showed that the improvement of image quality was related to how long it was since joining the medical association(β=0.32, P<0.05).Conclusions The image quality is improved after joining the medical association, and the extent to which the image quality is improved is related to how long it is since joining the medical association.