DICOM is a world-wide standard that can be used in every locale. It provides mechanisms to handle data that support cultural requirements, such as different writing systems, character sets, languages, and structures for addresses and person names. It supports the variety of workflows, processes and policies used for biomedical imaging in different geographic regions, medical specialties and local practices.

Localization to meet the requirements of national or local health and workflow policies can be done without deviating from the Standard. Such localization may include specifying code sets (e.g., procedure codes), or profiling data element usage (both specifying locally allowed values, and making elements that are optional in the Standard mandatory for local use).

Localization and profiling can be specified in a number of mechanisms outside the purview of the DICOM Standard. One such mechanism is Integration Profiles from the Integrating the Healthcare Enterprise (IHE) organization. It is important that Profiling adhere to the concept of non-contradiction. A Profile can add requirements but should not contradict DICOM requirements, as that would make it impossible to comply with both DICOM and the Profile.