In this study, we proposed pathological pattern detection system for X-ray chest image using artificial neural network. In a physical examination, radiologists have checked on the chest image projected the view box by a magnifying glass and found out what the disease is. Here, the detection of X-ray fluoroscopy is tedious and time-consuming for human doing. Lowering of efficiency for chest diagnosis is caused by lots mistakes of radiologist because of detecting the micro pathology from the film of small size. So, we proposed the method for disease detection using artificial neural network and digital image processing on a X-ray chest image. This method composes the function of image sampling, median filter, image equalizer used neural network and pattern recognition used neural network. We confirm this method has improved the problem of a conventional method.