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This paper describes the result of our investigation on the utilization pixels arrangement and random permutation to encrypt medical image for transmission security. The objective of this scheme is to obtain a high speed computation process and high security. Among other algorithms such as transform method and traditional method, pixels arrangement and permutation provide simple and quick processes; it particularly does not need any mathematical manipulation. This feature is especially very useful for medical image where the image can be very big. We tested the algorithm using gray-scale images. The scheme shows a good randomness and quick computation process. We closed the paper by discussing the strength and limitation of this for practical for example in telemedicine.