diff --git a/monailabel/endpoints/infer.py b/monailabel/endpoints/infer.py
index fee0232af..f66e2d0a4 100644
--- a/monailabel/endpoints/infer.py
+++ b/monailabel/endpoints/infer.py
@@ -24,7 +24,7 @@
 from requests_toolbelt import MultipartEncoder
 
 from monailabel.config import RBAC_USER, settings
-from monailabel.datastore.utils.convert import binary_to_image
+from monailabel.datastore.utils.convert import binary_to_image, nifti_to_dicom_seg
 from monailabel.endpoints.user.auth import RBAC, User
 from monailabel.interfaces.app import MONAILabelApp
 from monailabel.interfaces.utils.app import app_instance
@@ -62,6 +62,7 @@
                 },
                 "application/json": {"schema": {"type": "string", "example": "{}"}},
                 "application/octet-stream": {"schema": {"type": "string", "format": "binary"}},
+                "application/dicom": {"schema": {"type": "string", "format": "binary"}},
             },
         },
     },
@@ -72,6 +73,7 @@ class ResultType(str, Enum):
     image = "image"
     json = "json"
     all = "all"
+    dicom_seg = "dicom_seg"
 
 
 def send_response(datastore, result, output, background_tasks):
@@ -93,6 +95,13 @@ def send_response(datastore, result, output, background_tasks):
     if output == "image":
         return FileResponse(res_img, media_type=m_type, filename=os.path.basename(res_img))
 
+    if output == "dicom_seg":
+        res_dicom_seg = result.get("dicom_seg")
+        if res_dicom_seg is None:
+            raise HTTPException(status_code=500, detail="Error processing inference")
+        else:
+            return FileResponse(res_dicom_seg, media_type="application/dicom", filename=os.path.basename(res_dicom_seg))
+
     res_fields = dict()
     res_fields["params"] = (None, json.dumps(res_json), "application/json")
     if res_img and os.path.exists(res_img):
@@ -162,6 +171,22 @@ def run_inference(
     result = instance.infer(request)
     if result is None:
         raise HTTPException(status_code=500, detail="Failed to execute infer")
+
+    # Dicom Seg Integration
+    if output == "dicom_seg" and image:
+        dicom_seg_file = None
+        image_uri = instance.datastore().get_image_uri(image)
+        if not image_uri:
+            raise HTTPException(status_code=500, detail="Image not found")
+        elif p.get("label_info") is None:
+            raise HTTPException(status_code=404, detail="Parameters for DICOM Seg inference cannot be empty!")
+        # Transform image uri to id (similar to _to_id in local datastore)
+        suffixes = [".nii", ".nii.gz", ".nrrd"]
+        image_path = [image_uri.replace(suffix, "") for suffix in suffixes if image_uri.endswith(suffix)][0]
+        res_img = result.get("file") if result.get("file") else result.get("label")
+        dicom_seg_file = nifti_to_dicom_seg(image_path, res_img, p.get("label_info"), use_itk=True)
+        result["dicom_seg"] = dicom_seg_file
+
     return send_response(instance.datastore(), result, output, background_tasks)