diff --git a/extensions/cornerstone/babel.config.js b/extensions/cornerstone/babel.config.js
new file mode 100644
index 00000000000..fed6f05fecd
--- /dev/null
+++ b/extensions/cornerstone/babel.config.js
@@ -0,0 +1 @@
+module.exports = require("../../babel.config.js");
diff --git a/extensions/cornerstone/jest.config.js b/extensions/cornerstone/jest.config.js
new file mode 100644
index 00000000000..9055db5b51e
--- /dev/null
+++ b/extensions/cornerstone/jest.config.js
@@ -0,0 +1,13 @@
+const base = require('../../jest.config.base.js');
+const pkg = require('./package');
+
+module.exports = {
+  ...base,
+  name: pkg.name,
+  displayName: pkg.name,
+  // rootDir: "../.."
+  // testMatch: [
+  //   //`<rootDir>/platform/${pack.name}/**/*.spec.js`
+  //   "<rootDir>/platform/viewer/**/*.test.js"
+  // ]
+};
diff --git a/extensions/cornerstone/package.json b/extensions/cornerstone/package.json
index 13f85770588..9384c7e1c43 100644
--- a/extensions/cornerstone/package.json
+++ b/extensions/cornerstone/package.json
@@ -25,7 +25,9 @@
     "build": "cross-env NODE_ENV=production webpack --config .webpack/webpack.prod.js",
     "build:package": "yarn run build",
     "prepublishOnly": "yarn run build",
-    "start": "yarn run dev"
+    "start": "yarn run dev",
+    "test:unit": "jest --watchAll",
+    "test:unit:ci": "jest --ci --runInBand --collectCoverage"
   },
   "peerDependencies": {
     "@ohif/core": "^0.50.0",
diff --git a/extensions/cornerstone/src/init.js b/extensions/cornerstone/src/init.js
index 77c499167ec..b9764f41ec8 100644
--- a/extensions/cornerstone/src/init.js
+++ b/extensions/cornerstone/src/init.js
@@ -5,6 +5,7 @@ import csTools from 'cornerstone-tools';
 import merge from 'lodash.merge';
 import queryString from 'query-string';
 import initCornerstoneTools from './initCornerstoneTools.js';
+import measurementServiceMappingsFactory from './utils/measurementServiceMappings/measurementServiceMappingsFactory';
 
 function fallbackMetaDataProvider(type, imageId) {
   if (!imageId.includes('wado?requestType=WADO')) {
@@ -17,7 +18,7 @@ function fallbackMetaDataProvider(type, imageId) {
   const wadoRoot = window.store.getState().servers.servers[0].wadoRoot;
   const wadoRsImageId = `wadors:${wadoRoot}/studies/${qs.studyUID}/series/${
     qs.seriesUID
-  }/instances/${qs.objectUID}/frames/${qs.frame || 1}`;
+    }/instances/${qs.objectUID}/frames/${qs.frame || 1}`;
 
   return cornerstone.metaData.get(type, wadoRsImageId);
 }
@@ -32,9 +33,9 @@ cornerstone.metaData.addProvider(fallbackMetaDataProvider, -1);
  * @param {Object|Array} configuration.csToolsConfig
  */
 export default function init({ servicesManager, configuration }) {
-  const callInputDialog = (data, event, callback) => {
-    const { UIDialogService } = servicesManager.services;
+  const { UIDialogService, MeasurementService } = servicesManager.services;
 
+  const callInputDialog = (data, event, callback) => {
     if (UIDialogService) {
       let dialogId = UIDialogService.create({
         centralize: true,
@@ -107,6 +108,9 @@ export default function init({ servicesManager, configuration }) {
     tools.push(...toolsGroupedByType[toolsGroup])
   );
 
+  /* Measurement Service */
+  _connectToolsToMeasurementService(MeasurementService);
+
   /* Add extension tools configuration here. */
   const internalToolsConfig = {
     ArrowAnnotate: {
@@ -182,3 +186,111 @@ export default function init({ servicesManager, configuration }) {
   csTools.setToolActive('ZoomTouchPinch', {});
   csTools.setToolEnabled('Overlay', {});
 }
+
+const _initMeasurementService = measurementService => {
+  /* Initialization */
+  const { toAnnotation, toMeasurement } = measurementServiceMappingsFactory(measurementService);
+  const csToolsVer4MeasurementSource = measurementService.createSource(
+    'CornerstoneTools',
+    '4'
+  );
+
+  /* Matching Criterias */
+  const matchingCriteria = {
+    valueType: measurementService.VALUE_TYPES.POLYLINE,
+    points: 2,
+  };
+
+  /* Mappings */
+  measurementService.addMapping(
+    csToolsVer4MeasurementSource,
+    'Length',
+    matchingCriteria,
+    toAnnotation,
+    toMeasurement
+  );
+
+  return csToolsVer4MeasurementSource;
+};
+
+const _connectToolsToMeasurementService = measurementService => {
+  const csToolsVer4MeasurementSource = _initMeasurementService(measurementService);
+  const {
+    id: sourceId,
+    addOrUpdate,
+    getAnnotation,
+  } = csToolsVer4MeasurementSource;
+
+  /* Measurement Service Events */
+  cornerstone.events.addEventListener(
+    cornerstone.EVENTS.ELEMENT_ENABLED,
+    event => {
+      const {
+        MEASUREMENT_ADDED,
+        MEASUREMENT_UPDATED,
+      } = measurementService.EVENTS;
+
+      measurementService.subscribe(
+        MEASUREMENT_ADDED,
+        ({ source, measurement }) => {
+          if (![sourceId].includes(source.id)) {
+            const annotation = getAnnotation('Length', measurement.id);
+
+            console.log(
+              'Measurement Service [Cornerstone]: Measurement added',
+              measurement
+            );
+            console.log('Mapped annotation:', annotation);
+          }
+        });
+
+      measurementService.subscribe(
+        MEASUREMENT_UPDATED,
+        ({ source, measurement }) => {
+          if (![sourceId].includes(source.id)) {
+            const annotation = getAnnotation('Length', measurement.id);
+
+            console.log(
+              'Measurement Service [Cornerstone]: Measurement updated',
+              measurement
+            );
+            console.log('Mapped annotation:', annotation);
+          }
+        }
+      );
+
+      const addOrUpdateMeasurement = csToolsAnnotation => {
+        try {
+          const { toolName, toolType, measurementData } = csToolsAnnotation;
+          const csTool = toolName || measurementData.toolType || toolType;
+          csToolsAnnotation.id = measurementData._measurementServiceId;
+          const measurementServiceId = addOrUpdate(csTool, csToolsAnnotation);
+
+          if (!measurementData._measurementServiceId) {
+            addMeasurementServiceId(measurementServiceId, csToolsAnnotation);
+          }
+        } catch (error) {
+          console.warn('Failed to add or update measurement:', error);
+        }
+      };
+
+      const addMeasurementServiceId = (id, csToolsAnnotation) => {
+        const { measurementData } = csToolsAnnotation;
+        Object.assign(measurementData, { _measurementServiceId: id });
+      };
+
+      [
+        csTools.EVENTS.MEASUREMENT_ADDED,
+        csTools.EVENTS.MEASUREMENT_MODIFIED,
+      ].forEach(csToolsEvtName => {
+        event.detail.element.addEventListener(
+          csToolsEvtName,
+          ({ detail: csToolsAnnotation }) => {
+            console.log(`Cornerstone Element Event: ${csToolsEvtName}`);
+            addOrUpdateMeasurement(csToolsAnnotation);
+          }
+        );
+      });
+    }
+  );
+};
diff --git a/extensions/cornerstone/src/utils/measurementServiceMappings/measurementServiceMappingsFactory.js b/extensions/cornerstone/src/utils/measurementServiceMappings/measurementServiceMappingsFactory.js
new file mode 100644
index 00000000000..46a409e2312
--- /dev/null
+++ b/extensions/cornerstone/src/utils/measurementServiceMappings/measurementServiceMappingsFactory.js
@@ -0,0 +1,133 @@
+import cornerstone from 'cornerstone-core';
+
+const SUPPORTED_TOOLS = ['Length', 'EllipticalRoi', 'RectangleRoi', 'ArrowAnnotate'];
+
+const measurementServiceMappingsFactory = measurementService => {
+  /**
+   * Maps measurement service format object to cornerstone annotation object.
+   *
+   * @param {Measurement} measurement The measurement instance
+   * @param {string} definition The source definition
+   * @return {Object} Cornerstone annotation data
+   */
+  const toAnnotation = (measurement, definition) => {
+    const {
+      id,
+      label,
+      description,
+      points,
+      unit,
+      sopInstanceUID,
+      frameOfReferenceUID,
+      referenceSeriesUID,
+    } = measurement;
+
+    return {
+      toolName: definition,
+      measurementData: {
+        sopInstanceUid: sopInstanceUID,
+        frameOfReferenceUid: frameOfReferenceUID,
+        seriesInstanceUid: referenceSeriesUID,
+        unit,
+        text: label,
+        description,
+        handles: _getHandlesFromPoints(points),
+        _measurementServiceId: id,
+      },
+    };
+  };
+
+  /**
+   * Maps cornerstone annotation event data to measurement service format.
+   *
+   * @param {Object} cornerstone Cornerstone event data
+   * @return {Measurement} Measurement instance
+   */
+  const toMeasurement = csToolsAnnotation => {
+    const { element, measurementData } = csToolsAnnotation;
+    const tool =
+      csToolsAnnotation.toolType ||
+      csToolsAnnotation.toolName ||
+      measurementData.toolType;
+
+    const validToolType = toolName => SUPPORTED_TOOLS.includes(toolName);
+
+    if (!validToolType(tool)) {
+      throw new Error('Tool not supported');
+    }
+
+    const {
+      sopInstanceUid,
+      frameOfReferenceUid,
+      seriesInstanceUid,
+    } = _getAttributes(element);
+
+    const points = [];
+    points.push(measurementData.handles);
+
+    return {
+      id: measurementData._measurementServiceId,
+      sopInstanceUID: sopInstanceUid,
+      frameOfReferenceUID: frameOfReferenceUid,
+      referenceSeriesUID: seriesInstanceUid,
+      label: measurementData.text,
+      description: measurementData.description,
+      unit: measurementData.unit,
+      area: measurementData.cachedStats && measurementData.cachedStats.area, /* TODO: Add concept names instead (descriptor) */
+      type: _getValueTypeFromToolType(tool),
+      points: _getPointsFromHandles(measurementData.handles),
+    };
+  };
+
+  const _getAttributes = element => {
+    const enabledElement = cornerstone.getEnabledElement(element);
+    const imageId = enabledElement.image.imageId;
+    const sopInstance = cornerstone.metaData.get('instance', imageId);
+    const sopInstanceUid = sopInstance.sopInstanceUid;
+    const frameOfReferenceUid = sopInstance.frameOfReferenceUID;
+    const series = cornerstone.metaData.get('series', imageId);
+    const seriesInstanceUid = series.seriesInstanceUid;
+
+    return { sopInstanceUid, frameOfReferenceUid, seriesInstanceUid };
+  };
+
+  const _getValueTypeFromToolType = toolType => {
+    const { POLYLINE, ELLIPSE, POINT } = measurementService.VALUE_TYPES;
+
+    /* TODO: Relocate static value types */
+    const TOOL_TYPE_TO_VALUE_TYPE = {
+      Length: POLYLINE,
+      EllipticalRoi: ELLIPSE,
+      RectangleRoi: POLYLINE,
+      ArrowAnnotate: POINT,
+    };
+
+    return TOOL_TYPE_TO_VALUE_TYPE[toolType];
+  };
+
+  const _getPointsFromHandles = handles => {
+    let points = [];
+    Object.keys(handles).map(handle => {
+      if (['start', 'end'].includes(handle)) {
+        let point = {};
+        if (handles[handle].x) point.x = handles[handle].x;
+        if (handles[handle].y) point.y = handles[handle].y;
+        points.push(point);
+      }
+    });
+    return points;
+  };
+
+  const _getHandlesFromPoints = points => {
+    return points
+      .map((p, i) => (i % 10 === 0 ? { start: p } : { end: p }))
+      .reduce((obj, item) => Object.assign(obj, { ...item }), {});
+  };
+
+  return {
+    toAnnotation,
+    toMeasurement,
+  };
+};
+
+export default measurementServiceMappingsFactory;
diff --git a/extensions/cornerstone/src/utils/measurementServiceMappings/measurementServiceMappingsFactory.test.js b/extensions/cornerstone/src/utils/measurementServiceMappings/measurementServiceMappingsFactory.test.js
new file mode 100644
index 00000000000..f17a432815f
--- /dev/null
+++ b/extensions/cornerstone/src/utils/measurementServiceMappings/measurementServiceMappingsFactory.test.js
@@ -0,0 +1,80 @@
+import measurementServiceMappingsFactory from './measurementServiceMappingsFactory';
+
+jest.mock('cornerstone-core', () => ({
+  ...jest.requireActual('cornerstone-core'),
+  getEnabledElement: () => ({
+    image: { imageId: 123 },
+  }),
+  metaData: {
+    ...jest.requireActual('cornerstone-core').metaData,
+    get: () => ({
+      sopInstanceUid: "123",
+      frameOfReferenceUID: "123",
+      seriesInstanceUid: "123",
+    }),
+  },
+}));
+
+describe('measurementServiceMappings.js', () => {
+  let mappings;
+  let handles;
+  let points;
+  let csToolsAnnotation;
+  let measurement;
+  let measurementServiceMock;
+  let definition = 'Length';
+
+  beforeEach(() => {
+    measurementServiceMock = {
+      VALUE_TYPES: {
+        POLYLINE: 'value_type::polyline',
+        POINT: 'value_type::point',
+        ELLIPSE: 'value_type::ellipse',
+        MULTIPOINT: 'value_type::multipoint',
+        CIRCLE: 'value_type::circle',
+      },
+    };
+    mappings = measurementServiceMappingsFactory(measurementServiceMock);
+    handles = { start: { x: 1, y: 2 }, end: { x: 1, y: 2 } };
+    points = [{ x: 1, y: 2 }, { x: 1, y: 2 }];
+    csToolsAnnotation = {
+      toolName: definition,
+      measurementData: {
+        _measurementServiceId: 1,
+        sopInstanceUid: '123',
+        frameOfReferenceUid: '123',
+        seriesInstanceUid: '123',
+        handles,
+        text: 'Test',
+        description: 'Test',
+        unit: 'mm',
+      },
+    };
+    measurement = {
+      id: 1,
+      sopInstanceUID: '123',
+      frameOfReferenceUID: '123',
+      referenceSeriesUID: '123',
+      label: 'Test',
+      description: 'Test',
+      unit: 'mm',
+      type: measurementServiceMock.VALUE_TYPES.POLYLINE,
+      points: points,
+    };
+    jest.clearAllMocks();
+  });
+
+  describe('toAnnotation()', () => {
+    it('map measurement service format to annotation', async () => {
+      const mappedMeasurement = await mappings.toAnnotation(measurement, definition);
+      expect(mappedMeasurement).toEqual(csToolsAnnotation);
+    });
+  });
+
+  describe('toMeasurement()', () => {
+    it('map annotation to measurement service format', async () => {
+      const mappedAnnotation = await mappings.toMeasurement(csToolsAnnotation);
+      expect(mappedAnnotation).toEqual(measurement);
+    });
+  });
+});
diff --git a/jest.config.js b/jest.config.js
index 549f14da80d..f309576702f 100644
--- a/jest.config.js
+++ b/jest.config.js
@@ -10,7 +10,8 @@ module.exports = {
   // https://jestjs.io/docs/en/configuration#projects-array-string-projectconfig
   projects: [
     // "<rootDir>/extensions/*/jest.config.js",
-    "<rootDir>/platform/*/jest.config.js"
+    "<rootDir>/platform/*/jest.config.js",
+    "<rootDir>/extensions/*/jest.config.js"
   ],
   coverageDirectory: "<rootDir>/coverage/"
 };
diff --git a/platform/core/src/index.js b/platform/core/src/index.js
index 7f915003d13..f0b8dd2d44f 100644
--- a/platform/core/src/index.js
+++ b/platform/core/src/index.js
@@ -24,6 +24,7 @@ import {
   UINotificationService,
   UIModalService,
   UIDialogService,
+  MeasurementService,
 } from './services';
 
 const OHIF = {
@@ -55,6 +56,7 @@ const OHIF = {
   UINotificationService,
   UIModalService,
   UIDialogService,
+  MeasurementService,
 };
 
 export {
@@ -85,6 +87,7 @@ export {
   UINotificationService,
   UIModalService,
   UIDialogService,
+  MeasurementService,
 };
 
 export { OHIF };
diff --git a/platform/core/src/index.test.js b/platform/core/src/index.test.js
index b4a7026a07d..ac35a2543f5 100644
--- a/platform/core/src/index.test.js
+++ b/platform/core/src/index.test.js
@@ -13,6 +13,7 @@ describe('Top level exports', () => {
       'UINotificationService',
       'UIModalService',
       'UIDialogService',
+      'MeasurementService',
       //
       'utils',
       'studies',
diff --git a/platform/core/src/services/MeasurementService/MeasurementService.js b/platform/core/src/services/MeasurementService/MeasurementService.js
new file mode 100644
index 00000000000..1f4f734cda3
--- /dev/null
+++ b/platform/core/src/services/MeasurementService/MeasurementService.js
@@ -0,0 +1,481 @@
+import log from '../../log';
+import guid from '../../utils/guid';
+
+/**
+ * Measurement source schema
+ *
+ * @typedef {Object} MeasurementSource
+ * @property {number} id -
+ * @property {string} name -
+ * @property {string} version -
+ */
+
+/**
+ * Measurement schema
+ *
+ * @typedef {Object} Measurement
+ * @property {number} id -
+ * @property {string} sopInstanceUID -
+ * @property {string} frameOfReferenceUID -
+ * @property {string} referenceSeriesUID -
+ * @property {string} label -
+ * @property {string} description -
+ * @property {string} type -
+ * @property {string} unit -
+ * @property {number} area -
+ * @property {Array} points -
+ * @property {MeasurementSource} source -
+ */
+
+/* Measurement schema keys for object validation. */
+const MEASUREMENT_SCHEMA_KEYS = [
+  'id',
+  'sopInstanceUID',
+  'frameOfReferenceUID',
+  'referenceSeriesUID',
+  'label',
+  'description',
+  'type',
+  'unit',
+  'area', // TODO: Add concept names instead (descriptor)
+  'points',
+  'source',
+];
+
+const EVENTS = {
+  MEASUREMENT_UPDATED: 'event::measurement_updated',
+  MEASUREMENT_ADDED: 'event::measurement_added',
+};
+
+const VALUE_TYPES = {
+  POLYLINE: 'value_type::polyline',
+  POINT: 'value_type::point',
+  ELLIPSE: 'value_type::ellipse',
+  MULTIPOINT: 'value_type::multipoint',
+  CIRCLE: 'value_type::circle',
+};
+
+class MeasurementService {
+  constructor() {
+    this.sources = {};
+    this.mappings = {};
+    this.measurements = {};
+    this.listeners = {};
+    Object.defineProperty(this, 'EVENTS', {
+      value: EVENTS,
+      writable: false,
+      enumerable: true,
+      configurable: false,
+    });
+    Object.defineProperty(this, 'VALUE_TYPES', {
+      value: VALUE_TYPES,
+      writable: false,
+      enumerable: true,
+      configurable: false,
+    });
+  }
+
+  /**
+   * Get all measurements.
+   *
+   * @return {Measurement[]} Array of measurements
+   */
+  getMeasurements() {
+    const measurements = this._arrayOfObjects(this.measurements);
+    return (
+      measurements &&
+      measurements.map(m => this.measurements[Object.keys(m)[0]])
+    );
+  }
+
+  /**
+   * Get specific measurement by its id.
+   *
+   * @param {string} id If of the measurement
+   * @return {Measurement} Measurement instance
+   */
+  getMeasurement(id) {
+    let measurement = null;
+    const measurements = this.measurements[id];
+
+    if (measurements && Object.keys(measurements).length > 0) {
+      measurement = this.measurements[id];
+    }
+
+    return measurement;
+  }
+
+  /**
+   * Create a new source.
+   *
+   * @param {string} name Name of the source
+   * @param {string} version Source name
+   * @return {MeasurementSource} Measurement source instance
+   */
+  createSource(name, version) {
+    if (!name) {
+      log.warn('Source name not provided. Exiting early.');
+      return;
+    }
+
+    if (!version) {
+      log.warn('Source version not provided. Exiting early.');
+      return;
+    }
+
+    const id = guid();
+    const source = {
+      id,
+      name,
+      version,
+    };
+    source.addOrUpdate = (definition, measurement) => {
+      return this.addOrUpdate(source, definition, measurement);
+    };
+    source.getAnnotation = (definition, measurementId) => {
+      return this.getAnnotation(source, definition, measurementId);
+    };
+
+    log.info(`New '${name}@${version}' source added.`);
+    this.sources[id] = source;
+
+    return source;
+  }
+
+  /**
+   * Add a new measurement matching criteria along with mapping functions.
+   *
+   * @param {MeasurementSource} source Measurement source instance
+   * @param {string} definition Definition of the measurement (Annotation Type)
+   * @param {MatchingCriteria} matchingCriteria The matching criteria
+   * @param {Function} toSourceSchema Mapping function to source schema
+   * @param {Function} toMeasurementSchema Mapping function to measurement schema
+   * @return void
+   */
+  addMapping(
+    source,
+    definition,
+    matchingCriteria,
+    toSourceSchema,
+    toMeasurementSchema
+  ) {
+    if (!this._isValidSource(source)) {
+      log.warn('Invalid source. Exiting early.');
+      return;
+    }
+
+    if (!matchingCriteria) {
+      log.warn('Matching criteria not provided. Exiting early.');
+      return;
+    }
+
+    if (!definition) {
+      log.warn('Definition not provided. Exiting early.');
+      return;
+    }
+
+    if (!toSourceSchema) {
+      log.warn('Source mapping function not provided. Exiting early.');
+      return;
+    }
+
+    if (!toMeasurementSchema) {
+      log.warn('Measurement mapping function not provided. Exiting early.');
+      return;
+    }
+
+    const mapping = {
+      matchingCriteria,
+      definition,
+      toSourceSchema,
+      toMeasurementSchema,
+    };
+
+    if (Array.isArray(this.mappings[source.id])) {
+      this.mappings[source.id].push(mapping);
+    } else {
+      this.mappings[source.id] = [mapping];
+    }
+
+    log.info(`New measurement mapping added to source '${this._getSourceInfo(source)}'.`);
+  }
+
+  /**
+   * Get annotation for specific source.
+   *
+   * @param {MeasurementSource} source Measurement source instance
+   * @param {string} definition The source definition
+   * @param {string} measurementId The measurement service measurement id
+   * @return {Object} Source measurement schema
+   */
+  getAnnotation(source, definition, measurementId) {
+    if (!this._isValidSource(source)) {
+      log.warn('Invalid source. Exiting early.');
+      return;
+    }
+
+    if (!definition) {
+      log.warn('No source definition provided. Exiting early.');
+      return;
+    }
+
+    const mapping = this._getMappingByMeasurementSource(measurementId, definition);
+    if (mapping) return mapping.toSourceSchema(measurement, definition);
+
+    const measurement = this.getMeasurement(measurementId);
+    const matchingMapping = this._getMatchingMapping(source, definition, measurement);
+
+    if (matchingMapping) {
+      log.info('Matching mapping found:', matchingMapping);
+      const { toSourceSchema, definition } = matchingMapping;
+      return toSourceSchema(measurement, definition);
+    }
+  }
+
+  /**
+   * Adds or update persisted measurements.
+   *
+   * @param {MeasurementSource} source The measurement source instance
+   * @param {string} definition The source definition
+   * @param {Measurement} measurement The source measurement
+   * @return {string} A measurement id
+   */
+  addOrUpdate(source, definition, sourceMeasurement) {
+    if (!this._isValidSource(source)) {
+      log.warn('Invalid source. Exiting early.');
+      return;
+    }
+
+    const sourceInfo = this._getSourceInfo(source);
+
+    if (!definition) {
+      log.warn('No source definition provided. Exiting early.');
+      return;
+    }
+
+    if (!this._sourceHasMappings(source)) {
+      log.warn(`No measurement mappings found for '${sourceInfo}' source. Exiting early.`);
+      return;
+    }
+
+    let measurement = {};
+    try {
+      const sourceMappings = this.mappings[source.id];
+      const { toMeasurementSchema } = sourceMappings.find(
+        mapping => mapping.definition === definition
+      );
+
+      /* Convert measurement */
+      measurement = toMeasurementSchema(sourceMeasurement);
+
+      /* Assign measurement source instance */
+      measurement.source = source;
+    } catch (error) {
+      log.error(`Failed to map '${sourceInfo}' measurement for definition ${definition}:`, error.message);
+      return;
+    }
+
+    if (!this._isValidMeasurement(measurement)) {
+      log.warn(
+        `Attempting to add or update a invalid measurement provided by '${sourceInfo}'. Exiting early.`
+      );
+      return;
+    }
+
+    let internalId = sourceMeasurement.id;
+    if (!internalId) {
+      internalId = guid();
+      log.warn(`Measurement ID not found. Generating UID: ${internalId}`);
+    }
+
+    const newMeasurement = {
+      ...measurement,
+      modifiedTimestamp: Math.floor(Date.now() / 1000),
+      id: internalId,
+    };
+
+    if (this.measurements[internalId]) {
+      log.info(`Measurement already defined. Updating measurement.`, newMeasurement);
+      this.measurements[internalId] = newMeasurement;
+      this._broadcastChange(this.EVENTS.MEASUREMENT_UPDATED, source, newMeasurement);
+    } else {
+      log.info(`Measurement added.`, newMeasurement);
+      this.measurements[internalId] = newMeasurement;
+      this._broadcastChange(this.EVENTS.MEASUREMENT_ADDED, source, newMeasurement);
+    }
+
+    return newMeasurement.id;
+  }
+
+  /**
+   * Subscribe to measurement updates.
+   *
+   * @param {string} eventName The name of the event
+   * @param {Function} callback Events callback
+   * @return {Object} Observable object with actions
+   */
+  subscribe(eventName, callback) {
+    if (this._isValidEvent(eventName)) {
+      const listenerId = guid();
+      const subscription = { id: listenerId, callback };
+
+      console.info(`Subscribing to '${eventName}'.`);
+      if (Array.isArray(this.listeners[eventName])) {
+        this.listeners[eventName].push(subscription);
+      } else {
+        this.listeners[eventName] = [subscription];
+      }
+
+      return {
+        unsubscribe: () => this._unsubscribe(eventName, listenerId),
+      };
+    } else {
+      throw new Error(`Event ${eventName} not supported.`);
+    }
+  }
+
+  _getMappingByMeasurementSource(measurementId, definition) {
+    const measurement = this.getMeasurement(measurementId);
+    if (this._isValidSource(measurement.source)) {
+      return this.mappings[measurement.source.id].find(
+        m => m.definition === definition
+      );
+    }
+  }
+
+  /**
+   * Get measurement mapping function if matching criteria.
+   *
+   * @param {MeasurementSource} source Measurement source instance
+   * @param {string} definition The source definition
+   * @param {string} measurement The measurement serice measurement
+   * @return {Object} The mapping based on matched criteria
+   */
+  _getMatchingMapping(source, definition, measurement) {
+    const sourceMappings = this.mappings[source.id];
+
+    const sourceMappingsByDefinition = sourceMappings.filter(
+      mapping => mapping.definition === definition
+    );
+
+    /* Criteria Matching */
+    return sourceMappingsByDefinition.find(({ matchingCriteria }) => {
+      return (
+        measurement.points &&
+        measurement.points.length === matchingCriteria.points
+      );
+    });
+  }
+
+  /**
+   * Returns formatted string with source info.
+   *
+   * @param {MeasurementSource} source Measurement source
+   * @return {string} Source information
+   */
+  _getSourceInfo(source) {
+    return `${source.name}@${source.version}`;
+  }
+
+  /**
+   * Checks if given source is valid.
+   *
+   * @param {MeasurementSource} source Measurement source
+   * @return {boolean} Measurement source validation
+   */
+  _isValidSource(source) {
+    return source && this.sources[source.id];
+  }
+
+  /**
+   * Checks if a given source has mappings.
+   *
+   * @param {MeasurementSource} source The measurement source
+   * @return {boolean} Validation if source has mappings
+   */
+  _sourceHasMappings(source) {
+    return (
+      Array.isArray(this.mappings[source.id]) && this.mappings[source.id].length
+    );
+  }
+
+  /**
+   * Broadcasts measurement changes.
+   *
+   * @param {string} measurementId The measurement id
+   * @param {MeasurementSource} source The measurement source
+   * @param {string} eventName The event name
+   * @return void
+   */
+  _broadcastChange(eventName, source, measurement) {
+    const hasListeners = Object.keys(this.listeners).length > 0;
+    const hasCallbacks = Array.isArray(this.listeners[eventName]);
+
+    if (hasListeners && hasCallbacks) {
+      this.listeners[eventName].forEach(listener => {
+        listener.callback({ source, measurement });
+      });
+    }
+  }
+
+  /**
+   * Unsubscribe to measurement updates.
+   *
+   * @param {string} eventName The name of the event
+   * @param {string} listenerId The listeners id
+   * @return void
+   */
+  _unsubscribe(eventName, listenerId) {
+    if (!this.listeners[eventName]) {
+      return;
+    }
+
+    const listeners = this.listeners[eventName];
+    if (Array.isArray(listeners)) {
+      this.listeners[eventName] = listeners.filter(
+        ({ id }) => id !== listenerId
+      );
+    } else {
+      this.listeners[eventName] = undefined;
+    }
+  }
+
+  /**
+   * Check if a given measurement data is valid.
+   *
+   * @param {Measurement} measurementData Measurement data
+   * @return {boolean} Measurement validation
+   */
+  _isValidMeasurement(measurementData) {
+    Object.keys(measurementData).forEach(key => {
+      if (!MEASUREMENT_SCHEMA_KEYS.includes(key)) {
+        log.warn(`Invalid measurement key: ${key}`);
+        return false;
+      }
+    });
+
+    return true;
+  }
+
+  /**
+   * Check if a given measurement service event is valid.
+   *
+   * @param {string} eventName The name of the event
+   * @return {boolean} Event name validation
+   */
+  _isValidEvent(eventName) {
+    return Object.values(this.EVENTS).includes(eventName);
+  }
+
+  /**
+   * Converts object of objects to array.
+   *
+   * @return {Array} Array of objects
+   */
+  _arrayOfObjects = obj => {
+    return Object.entries(obj).map(e => ({ [e[0]]: e[1] }));
+  };
+}
+
+export default MeasurementService;
+export { EVENTS, VALUE_TYPES };
diff --git a/platform/core/src/services/MeasurementService/MeasurementService.test.js b/platform/core/src/services/MeasurementService/MeasurementService.test.js
new file mode 100644
index 00000000000..009ac40cdb9
--- /dev/null
+++ b/platform/core/src/services/MeasurementService/MeasurementService.test.js
@@ -0,0 +1,405 @@
+import MeasurementService from './MeasurementService.js';
+import log from '../../log';
+
+jest.mock('../../log.js', () => ({
+  info: jest.fn(),
+  warn: jest.fn(),
+  error: jest.fn(),
+}));
+
+describe('MeasurementService.js', () => {
+  let measurementService;
+  let measurement;
+  let source;
+  let definition;
+  let matchingCriteria;
+  let toAnnotation;
+  let toMeasurement;
+  let annotation;
+
+  beforeEach(() => {
+    measurementService = new MeasurementService();
+    source = measurementService.createSource('Test', '1');
+    definition = 'Length';
+    annotation = {
+      toolName: definition,
+      measurementData: {},
+    };
+    measurement = {
+      sopInstanceUID: '123',
+      frameOfReferenceUID: '1234',
+      referenceSeriesUID: '12345',
+      label: 'Label',
+      description: 'Description',
+      unit: 'mm',
+      area: 123,
+      type: measurementService.VALUE_TYPES.POLYLINE,
+      points: [{ x: 1, y: 2 }, { x: 1, y: 2 }],
+      source: source,
+    };
+    toAnnotation = () => annotation;
+    toMeasurement = () => measurement;
+    matchingCriteria = {
+      valueType: measurementService.VALUE_TYPES.POLYLINE,
+      points: 2,
+    };
+    log.warn.mockClear();
+    jest.clearAllMocks();
+  });
+
+  describe('createSource()', () => {
+    it('creates new source with name and version', () => {
+      measurementService.createSource('Testing', '1');
+    });
+
+    it('logs warning and return early if no name provided', () => {
+      measurementService.createSource(null, '1');
+
+      expect(log.warn.mock.calls.length).toBe(1);
+    });
+
+    it('logs warning and return early if no version provided', () => {
+      measurementService.createSource('Testing', null);
+
+      expect(log.warn.mock.calls.length).toBe(1);
+    });
+  });
+
+  describe('addMapping()', () => {
+    it('adds new mapping', () => {
+      measurementService.addMapping(
+        source,
+        definition,
+        matchingCriteria,
+        toAnnotation,
+        toMeasurement
+      );
+    });
+
+    it('logs warning and return early if no matching criteria provided', () => {
+      measurementService.addMapping(
+        source,
+        definition,
+        null,
+        toAnnotation,
+        toMeasurement
+      );
+
+      expect(log.warn.mock.calls.length).toBe(1);
+    });
+
+    it('logs warning and return early if invalid source provided', () => {
+      const invalidSoure = {};
+
+      measurementService.addMapping(
+        invalidSoure,
+        definition,
+        matchingCriteria,
+        toAnnotation,
+        toMeasurement
+      );
+
+      expect(log.warn.mock.calls.length).toBe(1);
+    });
+
+    it('logs warning and return early if no source provided', () => {
+      measurementService.addMapping(
+        null /* source */,
+        definition,
+        matchingCriteria,
+        toAnnotation,
+        toMeasurement
+      );
+
+      expect(log.warn.mock.calls.length).toBe(1);
+    });
+
+    it('logs warning and return early if no definition provided', () => {
+      measurementService.addMapping(
+        source,
+        null /* definition */,
+        matchingCriteria,
+        toAnnotation,
+        toMeasurement
+      );
+
+      expect(log.warn.mock.calls.length).toBe(1);
+    });
+
+    it('logs warning and return early if no measurement mapping function provided', () => {
+      measurementService.addMapping(
+        source,
+        definition,
+        matchingCriteria,
+        null /* toAnnotation */,
+        toMeasurement
+      );
+
+      expect(log.warn.mock.calls.length).toBe(1);
+    });
+
+    it('logs warning and return early if no annotation mapping function provided', () => {
+      measurementService.addMapping(
+        source,
+        definition,
+        matchingCriteria,
+        toAnnotation,
+        null /* toMeasurement */
+      );
+
+      expect(log.warn.mock.calls.length).toBe(1);
+    });
+  });
+
+  describe('getAnnotation()', () => {
+    it('get annotation based on matched criteria', () => {
+      measurementService.addMapping(
+        source,
+        definition,
+        matchingCriteria,
+        toAnnotation,
+        toMeasurement
+      );
+      const measurementId = source.addOrUpdate(definition, annotation);
+      const mappedAnnotation = source.getAnnotation(definition, measurementId);
+
+      expect(annotation).toBe(mappedAnnotation);
+    });
+
+    it('get annotation based on source and definition', () => {
+      measurementService.addMapping(
+        source,
+        definition,
+        {},
+        toAnnotation,
+        toMeasurement
+      );
+      const measurementId = source.addOrUpdate(definition, annotation);
+      const mappedAnnotation = source.getAnnotation(definition, measurementId);
+
+      expect(annotation).toBe(mappedAnnotation);
+    });
+  });
+
+  describe('getMeasurements()', () => {
+    it('return all measurement service measurements', () => {
+      const anotherMeasurement = {
+        ...measurement,
+        label: 'Label2',
+        unit: 'HU',
+      };
+
+      measurementService.addMapping(
+        source,
+        definition,
+        matchingCriteria,
+        toAnnotation,
+        toMeasurement
+      );
+
+      source.addOrUpdate(definition, measurement);
+      source.addOrUpdate(definition, anotherMeasurement);
+
+      const measurements = measurementService.getMeasurements();
+
+      expect(measurements.length).toEqual(2);
+      expect(measurements.length).toEqual(2);
+    });
+  });
+
+  describe('getMeasurement()', () => {
+    it('return measurement service measurement with given id', () => {
+      measurementService.addMapping(
+        source,
+        definition,
+        matchingCriteria,
+        toAnnotation,
+        toMeasurement
+      );
+
+      const id = source.addOrUpdate(definition, measurement);
+      const returnedMeasurement = measurementService.getMeasurement(id);
+
+      /* Clear dynamic data */
+      delete returnedMeasurement.modifiedTimestamp;
+
+      expect({ id, ...measurement }).toEqual(returnedMeasurement);
+    });
+  });
+
+  describe('addOrUpdate()', () => {
+    it('adds new measurements', () => {
+      measurementService.addMapping(
+        source,
+        definition,
+        matchingCriteria,
+        toAnnotation,
+        toMeasurement
+      );
+
+      source.addOrUpdate(definition, measurement);
+      source.addOrUpdate(definition, measurement);
+
+      const measurements = measurementService.getMeasurements();
+
+      expect(measurements.length).toBe(2);
+    });
+
+    it('fails to add new measurements when no mapping', () => {
+      source.addOrUpdate(definition, measurement);
+
+      expect(log.warn.mock.calls.length).toBe(1);
+    });
+
+    it('fails to add new measurements when invalid mapping function', () => {
+      measurementService.addMapping(
+        source,
+        definition,
+        matchingCriteria,
+        toAnnotation,
+        1 /* Invalid */
+      );
+
+      source.addOrUpdate(definition, measurement);
+
+      expect(log.error.mock.calls.length).toBe(1);
+    });
+
+    it('adds new measurement with custom id', () => {
+      const newMeasurement = { id: 1, ...measurement };
+
+      measurementService.addMapping(
+        source,
+        definition,
+        matchingCriteria,
+        toAnnotation,
+        toMeasurement
+      );
+
+      /* Add new measurement */
+      source.addOrUpdate(definition, newMeasurement);
+      const savedMeasurement = measurementService.getMeasurement(newMeasurement.id);
+
+      /* Clear dynamic data */
+      delete newMeasurement.modifiedTimestamp;
+      delete savedMeasurement.modifiedTimestamp;
+
+      expect(newMeasurement).toEqual(savedMeasurement);
+    });
+
+    it('logs warning and return if adding invalid measurement', () => {
+      measurement.invalidProperty = {};
+
+      measurementService.addMapping(
+        source,
+        definition,
+        matchingCriteria,
+        toAnnotation,
+        toMeasurement
+      );
+
+      source.addOrUpdate(definition, measurement);
+
+      expect(log.warn.mock.calls.length).toBe(2);
+    });
+
+    it('updates existent measurement', () => {
+      measurementService.addMapping(
+        source,
+        definition,
+        matchingCriteria,
+        toAnnotation,
+        toMeasurement
+      );
+
+      const id = source.addOrUpdate(definition, measurement);
+
+      measurement.unit = 'HU';
+
+      source.addOrUpdate(definition, { id, ...measurement });
+      const updatedMeasurement = measurementService.getMeasurement(id);
+
+      expect(updatedMeasurement.unit).toBe('HU');
+    });
+  });
+
+  describe('subscribe()', () => {
+    it('subscribers receive broadcasted add event', () => {
+      measurementService.addMapping(
+        source,
+        definition,
+        matchingCriteria,
+        toAnnotation,
+        toMeasurement
+      );
+
+      const { MEASUREMENT_ADDED } = measurementService.EVENTS;
+      let addCallbackWasCalled = false;
+
+      /* Subscribe to add event */
+      measurementService.subscribe(
+        MEASUREMENT_ADDED,
+        () => (addCallbackWasCalled = true)
+      );
+
+      /* Add new measurement */
+      source.addOrUpdate(definition, measurement);
+
+      expect(addCallbackWasCalled).toBe(true);
+    });
+
+    it('subscribers receive broadcasted update event', () => {
+      measurementService.addMapping(
+        source,
+        definition,
+        matchingCriteria,
+        toAnnotation,
+        toMeasurement
+      );
+
+      const { MEASUREMENT_UPDATED } = measurementService.EVENTS;
+      let updateCallbackWasCalled = false;
+
+      /* Subscribe to update event */
+      measurementService.subscribe(
+        MEASUREMENT_UPDATED,
+        () => (updateCallbackWasCalled = true)
+      );
+
+      /* Create measurement */
+      const id = source.addOrUpdate(definition, measurement);
+
+      /* Update measurement */
+      source.addOrUpdate(definition, { id, ...measurement });
+
+      expect(updateCallbackWasCalled).toBe(true);
+    });
+
+    it('unsubscribes a listener', () => {
+      measurementService.addMapping(
+        source,
+        definition,
+        matchingCriteria,
+        toAnnotation,
+        toMeasurement
+      );
+
+      let updateCallbackWasCalled = false;
+      const { MEASUREMENT_ADDED } = measurementService.EVENTS;
+
+      /* Subscribe to Add event */
+      const { unsubscribe } = measurementService.subscribe(
+        MEASUREMENT_ADDED,
+        () => (updateCallbackWasCalled = true)
+      );
+
+      /* Unsubscribe */
+      unsubscribe();
+
+      /* Create measurement */
+      source.addOrUpdate(definition, measurement);
+
+      expect(updateCallbackWasCalled).toBe(false);
+    });
+  });
+});
diff --git a/platform/core/src/services/MeasurementService/index.js b/platform/core/src/services/MeasurementService/index.js
new file mode 100644
index 00000000000..308f7401d92
--- /dev/null
+++ b/platform/core/src/services/MeasurementService/index.js
@@ -0,0 +1,8 @@
+import MeasurementService from './MeasurementService';
+
+export default {
+  name: 'MeasurementService',
+  create: ({ configuration = {} }) => {
+    return new MeasurementService();
+  },
+};
diff --git a/platform/core/src/services/index.js b/platform/core/src/services/index.js
index 9ac507c506e..a7fa17072f5 100644
--- a/platform/core/src/services/index.js
+++ b/platform/core/src/services/index.js
@@ -2,10 +2,12 @@ import ServicesManager from './ServicesManager.js';
 import UINotificationService from './UINotificationService';
 import UIModalService from './UIModalService';
 import UIDialogService from './UIDialogService';
+import MeasurementService from './MeasurementService';
 
 export {
   UINotificationService,
   UIModalService,
   UIDialogService,
   ServicesManager,
+  MeasurementService,
 };
diff --git a/platform/viewer/src/App.js b/platform/viewer/src/App.js
index fc07a85669d..a835fbfa187 100644
--- a/platform/viewer/src/App.js
+++ b/platform/viewer/src/App.js
@@ -23,6 +23,7 @@ import {
   UINotificationService,
   UIModalService,
   UIDialogService,
+  MeasurementService,
   utils,
   redux as reduxOHIF,
 } from '@ohif/core';
@@ -122,7 +123,12 @@ class App extends Component {
     } = this._appConfig;
 
     this.initUserManager(oidc);
-    _initServices([UINotificationService, UIModalService, UIDialogService]);
+    _initServices([
+      UINotificationService,
+      UIModalService,
+      UIDialogService,
+      MeasurementService,
+    ]);
     _initExtensions(
       [...defaultExtensions, ...extensions],
       cornerstoneExtensionConfig,
@@ -144,6 +150,7 @@ class App extends Component {
       UINotificationService,
       UIDialogService,
       UIModalService,
+      MeasurementService,
     } = servicesManager.services;
 
     if (this._userManager) {