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Emerging the microelectronics technology causes the decreasing of medical equipment price, also for ultrasound diagnostic machine. Low cost ultrasound diagnostic machine has very big market, especially for developing country. Unfortunately, the quality of image and safety performance of most low cost ultrasound diagnostic machine is not fulfilling the international standard requirement yet. As proposed in the several standards, the important parameters that should be considered in ultrasound image quality are the near field distance, penetration depth, vertical distance accuracy, horizontal distance accuracy, axial resolution, lateral resolution and high scatter accuracy. In order to ensure that the image quality is good enough for medical diagnostic, an automatic monitoring system has been developed. Test result shows that most low cost ultrasound machines have low image quality. The system is suitable to monitor and improve the ultrasound image quality of low cost ultrasound machine.